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General NPI Number Information
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NPI Number | 1851025985
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Entity Type | Individual
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Provider Name | STEPHANIE JEAN CRANE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 750 BOWLING LN
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City | WAUPACA
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State | WI
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Zip | 54981-7707
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Country | US
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Telephone | 715-204-4968
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Fax |
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Provider Business Mailing Address
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Address Line | N3620 TOMORROW RIVER LN
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City | WAUPACA
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State | WI
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Zip | 54981-8745
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Country | US
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Telephone | 152-044-9687
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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 | 9961123
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License Number State | WI
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