Provider Demographics
NPI:1093737611
Name:ALE, STEPHANIE S (DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:S
Last Name:ALE
Suffix:
Gender:F
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 E GRANT ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WOODSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-1400
Mailing Address - Country:US
Mailing Address - Phone:856-769-4564
Mailing Address - Fax:856-769-4637
Practice Address - Street 1:84 E GRANT ST
Practice Address - Street 2:SUITE 3
Practice Address - City:WOODSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08098-1400
Practice Address - Country:US
Practice Address - Phone:856-769-4564
Practice Address - Fax:856-769-4637
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA01203000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist