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Individual
STEPHANIE LYNN MARCEAUX
Active
Individual
STEPHANIE LYNN MARCEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT02051
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316264153
GROUP NPI
LA
01
—
1821153016
GROUP MEMBER NPI
LA
01
—
5DT76
GROUP PTAN
LA
01
—
5X761DT76
GROUP MEMBER PTAN
LA
Enumeration date
12/27/2006
Last updated
08/10/2012
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