Doctor Name: | STEPHANIE REDDING |
NPI Number: | 1124230206 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | LAC 1068 |
Business Practice Address: | 1601 W 4th St Coffeyville, KS - 673373333 |
Business Phone Number: | 6202518180 |
Business Fax Number: | |
Mailing Address: | 1601 W 4th St, COFFEYVILLE |
State: | KS |
Postal Code: | 673373333 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 12/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LAC 1068 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |