Basic Information
| Provider Information | |||||||||
| NPI: | 1154677003 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALDERSON | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | LYN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MEISEL | ||||||||
| OtherFirstName: | STEPHANIE | ||||||||
| OtherMiddleName: | LYN | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2227 OLD EMMORTON RD | ||||||||
| Address2: | SUITE 121 | ||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210156187 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4435120423 | ||||||||
| FaxNumber: | 4435120425 | ||||||||
| Practice Location | |||||||||
| Address1: | 2227 OLD EMMORTON RD | ||||||||
| Address2: | SUITE 121 | ||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210156187 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4435120423 | ||||||||
| FaxNumber: | 4435120425 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2012 | ||||||||
| LastUpdateDate: | 07/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 23996 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.