Provider Demographics
NPI:1891277133
Name:BECHTOL, STEPHANIE
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:
Last Name:BECHTOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH STAR
Mailing Address - State:OH
Mailing Address - Zip Code:45350
Mailing Address - Country:US
Mailing Address - Phone:419-852-0766
Mailing Address - Fax:
Practice Address - Street 1:54 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:NORTH STAR
Practice Address - State:OH
Practice Address - Zip Code:45350
Practice Address - Country:US
Practice Address - Phone:419-852-0766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program