Individual
STEPHANIE H CLINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LAT, ATC
Contact information
Practice address
5151 PARK AVE, FAIRFIELD, CT 06825-1090
(203) 365-4475
Mailing address
5151 PARK AVE, FAIRFIELD, CT 06825-1090
(203) 365-4475
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000815
CT
2255A2300X
Athletic Trainer
0126002493
VA
2255A2300X
Athletic Trainer
2011016897
MO
Other
Enumeration date
03/28/2012
Last updated
09/29/2018
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