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NPI Code Detail

MEDICARE: KATHRYN STEVENSON MFT

MEDICARE: KATHRYN STEVENSON MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist4101006524MI

General Provider Information

NPI Number : 1013135664
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN STEVENSON MFT
Provider Business Mailing Address
First Line : 1422 W SAGINAW ST
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-2434
Country : US
Telephone Number : 510-393-3360
Fax Number :
Provider Business Practice Location Address
First Line : 1422 W SAGINAW ST
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-2434
Country : US
Telephone Number : 510-393-3360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2007
Last Update Date : 08/06/2015

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Directions to “ KATHRYN STEVENSON MFT” Practice Location

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