Provider Demographics
NPI:1295398444
Name:NALEPA HUDGE, STEPHANIE KAY (MS, QBHP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KAY
Last Name:NALEPA HUDGE
Suffix:
Gender:F
Credentials:MS, QBHP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:KAY
Other - Last Name:NALEPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, QBHP
Mailing Address - Street 1:524 BYRON RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1410
Mailing Address - Country:US
Mailing Address - Phone:989-941-6172
Mailing Address - Fax:
Practice Address - Street 1:524 BYRON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1410
Practice Address - Country:US
Practice Address - Phone:989-941-6172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106S00000X
247200000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other