Doctor Name: | MRS. JUDY ROYCE STEDJE |
NPI Number: | 1649558057 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPC LLC MEMBER |
License Number: | 58510 |
Business Practice Address: | 216 Nw 4th St Guymon, OK - 739424709 |
Business Phone Number: | 5803387082 |
Business Fax Number: | 5803387082 |
Mailing Address: | 216 Nw 4th St, GUYMON |
State: | OK |
Postal Code: | 739424709 |
Phone Number: | 5803387082 |
Fax Number: | 5803387082 |
NPI Enumeration Date: | 08/02/2011 |
NPI Last Update Date: | 08/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 58510 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |