Provider Demographics
NPI:1073777355
Name:SANDERS-HOWARD, STEPHANIE (MOTR/L)
Entity Type:Individual
Prefix:MR
First Name:STEPHANIE
Middle Name:
Last Name:SANDERS-HOWARD
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ANNA GOODE WAY
Mailing Address - Street 2:L.P.W.
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434
Mailing Address - Country:US
Mailing Address - Phone:757-539-1526
Mailing Address - Fax:
Practice Address - Street 1:100 ANNA GOODE WAY
Practice Address - Street 2:L.P.W.
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434
Practice Address - Country:US
Practice Address - Phone:757-539-1526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119001823225X00000X
NC5794225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist