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Individual

STEPHANIE FAY MAYEAUX

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MS,ATC,LAT

Contact information

Practice address
816 HARDING ST, LAFAYETTE, LA 70503-2320
(337) 232-3111
Mailing address
2314 KALISTE SALOOM RD, NUMBER 508, LAFAYETTE, LA 70508-6803
(337) 988-1766

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J00317
LA

Other

Enumeration date
09/01/2005
Last updated
07/08/2007
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