Individual
MARION T STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5109 WORLD DAIRY DR, MADISON, WI 53718-3807
(608) 242-0220
Mailing address
1209 CHERRY AVE STE 202, MADISON, WI 53714-1205
(920) 664-2490
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4090-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42229700
—
WI
Enumeration date
06/23/2011
Last updated
07/21/2022
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