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General NPI Number Information
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NPI Number | 1043490899
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Entity Type | Individual
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Provider Name | WALTER FABIAN REDLER PSYD, LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 11510 INTERCHANGE CIR N
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City | MIRAMAR
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State | FL
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Zip | 33025-6006
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Country | US
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Telephone | 954-237-0355
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Fax | 866-632-6439
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Provider Business Mailing Address
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Address Line | 11510 INTERCHANGE CIR N
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City | MIRAMAR
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State | FL
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Zip | 33025-6006
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Country | US
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Telephone | 954-237-0355
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Fax | 866-632-6439
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW5782
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | SW5782
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW5782
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | SW5782
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License Number State | FL
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