Provider Demographics
NPI:1235612557
Name:RICE, STEPHANIE JOAN
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOAN
Last Name:RICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:JOAN
Other - Last Name:JOURNAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 E 91ST ST STE 109
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1550
Mailing Address - Country:US
Mailing Address - Phone:317-218-4081
Mailing Address - Fax:
Practice Address - Street 1:70 E 91ST ST STE 109
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1550
Practice Address - Country:US
Practice Address - Phone:317-218-4081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker