| NPI | 1043747595 |
|---|---|
| Former Name | STEPHANIE MICHELLE STANLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AR 2763) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2955) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-07-21 |