Provider Demographics
NPI:1346595618
Name:MEYER, STEPHENIE RENEE' (AA)
Entity Type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:RENEE'
Last Name:MEYER
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-2045
Mailing Address - Country:US
Mailing Address - Phone:402-770-9218
Mailing Address - Fax:
Practice Address - Street 1:807 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-2045
Practice Address - Country:US
Practice Address - Phone:402-770-9218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst