Provider Demographics
NPI:1588874705
Name:SETA, STEPHENIE KATHRYN
Entity type:Individual
Prefix:MRS
First Name:STEPHENIE
Middle Name:KATHRYN
Last Name:SETA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S GRAND AVE
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-2122
Mailing Address - Country:US
Mailing Address - Phone:859-250-7618
Mailing Address - Fax:
Practice Address - Street 1:4552 PATRON CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-5808
Practice Address - Country:US
Practice Address - Phone:513-661-6764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities