Individual
AMANDA STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1325 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-9867
(406) 541-3032
Mailing address
3255 LT MOSS RD, MISSOULA, MT 59804-7220
(406) 532-9867
(406) 541-3032
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAC-LAC-LIC-4104
MT
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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