Basic Information
| Provider Information | |||||||||
| NPI: | 1689067977 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HAND | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 INTERNATIONAL PKWY STE 200 | ||||||||
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| City: | LAKE MARY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327465028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079157729 | ||||||||
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| Practice Location | |||||||||
| Address1: | 17815 HUNTING BOW CIR | ||||||||
| Address2: | |||||||||
| City: | LUTZ | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335585401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134914425 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2015 | ||||||||
| LastUpdateDate: | 05/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106E00000X | FL | N | 106S00000X | N | 222Q00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | 103K00000X | 1-19-35157 | FL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.