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General NPI Number Information
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NPI Number | 1619646528
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Entity Type | Individual
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Provider Name | DRESDAN STEPHENS
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Gender | Female
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 105 E OHIO ST
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-1917
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Country | US
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Telephone | 740-823-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 5439 BURKHARDT RD
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City | DAYTON
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State | OH
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Zip | 45431-2111
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Country | US
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Telephone |
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | S.2207434
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License Number State | OH
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