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Individual
MRS. MARY ELLEN STEPHENSON
Active
Individual
MRS. MARY ELLEN STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
00476
MO
2251G0304X
Geriatric Physical Therapist
00476
MO
2251P0200X
Pediatric Physical Therapist
Primary
00476
MO
Other
Enumeration date
03/13/2007
Last updated
05/11/2017
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