MEDICARE: DR. SHERRY STRAFFORD REDIGER MFT, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	35000969A	IN

General Provider Information

NPI Number	:	1972892941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERRY STRAFFORD REDIGER MFT, PHD

Provider Business Mailing Address
First Line	:	907 E MAIN ST
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-1677
Country	:	US
Telephone Number	:	317-839-1333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1012 STAFFORD RD
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-2228
Country	:	US
Telephone Number	:	317-839-1333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2011
Last Update Date	:	03/30/2011

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