Dr. Mallory Stevens, LP
Psychologist, School in Woodbury, MN. Individual provider (NPI-1).
NPI number1497482012
StatusActive
Last updated in NPPESSep 24, 2024
Details
- NPI
- 1497482012
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mallory Stevens
- Credential
- LP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 3, 2022
- Certification date
- Sep 24, 2024
- Last updated
- Sep 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TS0200X | Psychologist, School | LP7087 | MN | Yes |
Practice location
721 Commerce DrWoodbury, MN 55125-9118
Phone 651-275-7400
Mailing address
721 Commerce DrWoodbury, MN 55125-9118
Phone 612-767-7222
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