Provider Demographics
NPI:1538120522
Name:LEOPOLD, STEPHANIE MANON (PT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MANON
Last Name:LEOPOLD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 JUNKER ST
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5342
Mailing Address - Country:US
Mailing Address - Phone:281-344-0344
Mailing Address - Fax:
Practice Address - Street 1:4021 JUNKER ST
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5342
Practice Address - Country:US
Practice Address - Phone:281-344-0344
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1146690225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist