Provider Demographics
NPI:1508023615
Name:HAYDEN, STEPHANIE TITZER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:TITZER
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:F
Other - Last Name:TITZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:414 SE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1206
Mailing Address - Country:US
Mailing Address - Phone:812-423-4700
Mailing Address - Fax:812-421-2618
Practice Address - Street 1:414 SE 4TH ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-1206
Practice Address - Country:US
Practice Address - Phone:812-423-4700
Practice Address - Fax:812-421-2618
Is Sole Proprietor?:No
Enumeration Date:2008-05-18
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042241A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist