Provider Demographics
NPI:1942302401
Name:CARTER, STEPHANIE REDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:REDER
Last Name:CARTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SW 27TH AVE
Mailing Address - Street 2:APT. 1902
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-5307
Mailing Address - Country:US
Mailing Address - Phone:305-284-1143
Mailing Address - Fax:305-667-9880
Practice Address - Street 1:7325 SW 63RD AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4811
Practice Address - Country:US
Practice Address - Phone:305-284-1143
Practice Address - Fax:305-667-9880
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4293103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling