| NPI | 1396364022 |
|---|---|
| Former Name | STEPHANIE CARRILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2025-08-12 |