Provider Demographics
NPI:1346316742
Name:REDLE, STEPHEN M (PHD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:REDLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-2520
Mailing Address - Country:US
Mailing Address - Phone:330-926-0760
Mailing Address - Fax:330-926-1944
Practice Address - Street 1:2321 2ND ST
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-2520
Practice Address - Country:US
Practice Address - Phone:330-926-0760
Practice Address - Fax:330-926-1944
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5555103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist