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Individual
STACEY HENGST
Active
Individual
STACEY HENGST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00773300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2412770000
AMERIHEALTH
NJ
01
—
3637222000
DEPT. OF LABOR
NJ
Enumeration date
12/29/2006
Last updated
03/18/2020
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