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General NPI Number Information
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NPI Number | 1992847628
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Entity Type | Individual
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Provider Name | MARYJO KOEN STEPP MFT
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 600 F STREET
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City | ARCATA
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State | CA
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Zip | 95521
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Country | US
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Telephone | 707-601-6434
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Fax |
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Provider Business Mailing Address
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Address Line | 600 F STREET SUITE 3, # 203
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City | ARCATA
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State | CA
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Zip | 95521
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Country | US
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Telephone | 707-601-5553
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFC 40064
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFT40064
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License Number State | CA
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