Provider Demographics
NPI:1972316065
Name:DILLINGHAM, STEPHANIE JOYCE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOYCE
Last Name:DILLINGHAM
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 1:808 CATALPA AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2530
Mailing Address - Country:US
Mailing Address - Phone:419-230-7340
Mailing Address - Fax:
Practice Address - Street 1:808 CATALPA AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2530
Practice Address - Country:US
Practice Address - Phone:419-230-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program