Provider Demographics
NPI:1568674422
Name:HAMEL, STEPHANIE JOAN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JOAN
Last Name:HAMEL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:ME
Mailing Address - Zip Code:04489-0110
Mailing Address - Country:US
Mailing Address - Phone:207-827-2045
Mailing Address - Fax:
Practice Address - Street 1:1 CUMBERLAND PL STE 108
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5087
Practice Address - Country:US
Practice Address - Phone:207-990-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA2110225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant