| Doctor Name: | JOANN T. RADEKE |
| NPI Number: | 1508830027 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | JOANN T. RADEKE |
| License Number: | 30886 |
| Business Practice Address: | 1004 S Washington St Suite 110 Kaufman, TX - 751422739 |
| Business Phone Number: | 9729323941 |
| Business Fax Number: | 9729324941 |
| Mailing Address: | Po Box 517, KAUFMAN |
| State: | TX |
| Postal Code: | 751420517 |
| Phone Number: | 9729323941 |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 30886 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |