Individual
MRS. STEPHANIE LYNN STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
550 BRANDON AVE, ROOM 331, CHARLOTTESVILLE, VA 22903
(815) 451-6149
Mailing address
607 MEADOW LN, HARVARD, IL 60033-8359
(815) 451-6149
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003190
VA
Other
Enumeration date
09/29/2015
Last updated
09/08/2022
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