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Individual

MR. SHANE STAEDTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSCSW

Contact information

Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 239-7000
(630) 570-5779
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
125
KS
104100000X
Social Worker
Primary
4032
KS

Other

Enumeration date
06/25/2007
Last updated
07/11/2023
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