Provider Demographics
NPI:1588827497
Name:REDMAN, STACEY LEIGH (M ED)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:LEIGH
Last Name:REDMAN
Suffix:
Gender:F
Credentials:M ED
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 504
Mailing Address - Street 2:
Mailing Address - City:NEW HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03256-0504
Mailing Address - Country:US
Mailing Address - Phone:603-744-3299
Mailing Address - Fax:
Practice Address - Street 1:36 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03256-0504
Practice Address - Country:US
Practice Address - Phone:603-744-3299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH35106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist