| NPI | 1861648024 |
|---|---|
| Former Name | STEPHANIE LYNN BAUDENDISTEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 031741-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009418) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2013-05-10 |