| NPI | 1982939112 |
|---|---|
| Former Name | STEPHANIE FAYE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT3967) |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2020-06-02 |