Provider Demographics
NPI:1972080307
Name:KIESEL-KAUHANE, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:KIESEL-KAUHANE
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 1:220 W. KENNEWICK, AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-3812
Mailing Address - Country:US
Mailing Address - Phone:509-579-0006
Mailing Address - Fax:855-500-7738
Practice Address - Street 1:220 W. KENNEWICK, AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3812
Practice Address - Country:US
Practice Address - Phone:509-579-0006
Practice Address - Fax:855-500-7738
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist