Provider Demographics
NPI:1083177281
Name:ULSHAFER, STEPHANIE (ATC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ULSHAFER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CATAWBA CIR APT 319
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5266
Mailing Address - Country:US
Mailing Address - Phone:804-980-0265
Mailing Address - Fax:
Practice Address - Street 1:1300 WHEAT ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-3515
Practice Address - Country:US
Practice Address - Phone:803-777-2185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-13
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program