Individual
MRS. STEPHANIE ANN CLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, CSCS
Contact information
Practice address
616 GARRISONVILLE RD, STAFFORD, VA 22554-3707
(860) 287-9418
Mailing address
3 VARONE DR, STAFFORD, VA 22554-7897
(860) 287-9418
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001859
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126001859
VIRGINIA STATE LICENSE
VA
01
—
06-6000798
ATHLETIC TRAINER
CT
01
—
5435719UPD
NEW YORK LICENSE
NY
01
—
RT00448
PENNSYLVANIA LICENSE
PA
Enumeration date
04/10/2006
Last updated
10/30/2012
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