Provider Demographics
NPI:1669018511
Name:STUBBS, STEPHANIE CULPEPPER (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CULPEPPER
Last Name:STUBBS
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:CULPEPPER
Other - Last Name:STUBBS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:STEPHANIE STUBBS
Mailing Address - Street 1:600 BLOEDEL AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36784-2758
Mailing Address - Country:US
Mailing Address - Phone:334-564-0425
Mailing Address - Fax:
Practice Address - Street 1:29461 HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-5737
Practice Address - Country:US
Practice Address - Phone:334-564-0425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty