Individual
MARK STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
312 MILLER ST, LEWISTON, ID 83501-1944
(208) 750-1802
(208) 750-1803
Mailing address
2513 9TH AVE, LEWISTON, ID 83501-3459
(208) 816-0721
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC677
ID
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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