Provider Demographics
NPI:1881019867
Name:STEELE-WREN, STEPHANIE E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:E
Last Name:STEELE-WREN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 SE 28TH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4268
Mailing Address - Country:US
Mailing Address - Phone:833-779-9675
Mailing Address - Fax:833-779-9675
Practice Address - Street 1:809 SE 28TH ST STE 1
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4268
Practice Address - Country:US
Practice Address - Phone:338-779-9675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10542101YP2500X
AR202154103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist