Provider Demographics
NPI:1154677003
Name:ALDERSON, STEPHANIE LYN (DPT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYN
Last Name:ALDERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LYN
Other - Last Name:MEISEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2227 OLD EMMORTON RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6187
Mailing Address - Country:US
Mailing Address - Phone:443-512-0423
Mailing Address - Fax:443-512-0425
Practice Address - Street 1:2227 OLD EMMORTON RD
Practice Address - Street 2:SUITE 121
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6187
Practice Address - Country:US
Practice Address - Phone:443-512-0423
Practice Address - Fax:443-512-0425
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist