Provider Demographics
NPI:1558340588
Name:NEIDERMYER, STEPHANIE (LMFT, LLC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:NEIDERMYER
Suffix:
Gender:F
Credentials:LMFT, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68485
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-8485
Mailing Address - Country:US
Mailing Address - Phone:520-820-8871
Mailing Address - Fax:520-376-1730
Practice Address - Street 1:7440 N ORACLE RD BLDG 7
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6371
Practice Address - Country:US
Practice Address - Phone:520-333-7618
Practice Address - Fax:520-376-1730
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10427106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist