Provider Demographics
NPI:1790558260
Name:ARNOLD, STEPHANIE D (PTA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:D
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:RANAE
Other - Last Name:DUSENBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4536 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4536 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3057
Practice Address - Country:US
Practice Address - Phone:225-928-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA10922225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant