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General NPI Number Information
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NPI Number | 1659149680
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Entity Type | Individual
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Provider Name | STEPHANIE B TADDEO MSW
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Gender | Female
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 1145 N HIGH ST UNIT 603
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City | COLUMBUS
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State | OH
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Zip | 43201-2487
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Country | US
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Telephone | 419-565-5898
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Fax |
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Provider Business Mailing Address
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Address Line | 1145 N HIGH ST UNIT 603
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City | COLUMBUS
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State | OH
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Zip | 43201-2487
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Country | US
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Telephone | 419-565-5898
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.0900220.SUPV
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License Number State | OH
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