Provider Demographics
NPI:1245483130
Name:MCALLISTER, STEPHANIE JOY (DPT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOY
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:DPT
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 223
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21863-0223
Mailing Address - Country:US
Mailing Address - Phone:443-235-8183
Mailing Address - Fax:443-775-7713
Practice Address - Street 1:114 PEARL ST
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:MD
Practice Address - Zip Code:21863-1201
Practice Address - Country:US
Practice Address - Phone:443-235-8183
Practice Address - Fax:443-775-7713
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD 22694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD435138000Medicaid
MD435138000Medicaid
MD216538Medicare Oscar/Certification