| NPI | 1164624359 | 
|---|---|
| Former Name | STEPHANIE ANN BLOOMFIELD | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009875A)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1172308)  | 
| Enumeration Date | 2007-06-01 | 
| Last Update Date | 2012-12-19 |