| Doctor Name: | STEPHANIE F KANE |
| NPI Number: | 1003279894 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | LGP6939 |
| Business Practice Address: | 37 Main St Reisterstown, MD - 211361236 |
| Business Phone Number: | 4105267882 |
| Business Fax Number: | |
| Mailing Address: | 37 Main St, REISTERSTOWN |
| State: | MD |
| Postal Code: | 211361236 |
| Phone Number: | 4105267882 |
| Fax Number: | |
| NPI Enumeration Date: | 03/30/2016 |
| NPI Last Update Date: | 03/30/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LGP6939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |