Wade, Stefanie G
Wade, Stefanie G is an individual health care provider with primary practice located at 313 S 3Rd St , Goshen IN 46526-3709. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wade, Stefanie G can be contacted via phone (574) 535-0880.Contact Information
Primary practice address
313 S 3Rd St
Goshen IN 46526-3709
Phone: (574) 535-0880
Fax: (574) 535-0882
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20042314A | Indiana |
Profile Details
| NPI number | 1841310471 |
|---|---|
| LBN Legal business name | Wade, Stefanie G |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2007 |
| Last updated | Dec 4th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841310471 | NPPES |
| Indiana | MEDICAID | 200938090A |
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