Most Relevant Information
Provider Data
| NPI Number: | 1003405085 |
| Provider Name: | STEPHANIE LYNN CALLEN LSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | LSW-38944 |
Most Important Dates
| Enumeration Date: | 01/13/2021 |
| Last Updated: | 01/13/2021 |
Provider Practice Location
630 ADDISON AVE W STE 1000
TWIN FALLS
ID
833015853
Practice Location Phone/Fax
| Phone: | 2087365048 |
| Fax: |
Provider Mailing Location
630 ADDISON AVE W STE 1000
TWIN FALLS
ID
833015853
Provider Mailing Phone/Fax
| Phone: | 2087365048 |
| Fax: |