Provider Demographics
NPI:1265762181
Name:BROWN, STEPHANIE A (MSPT)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-1803
Mailing Address - Country:US
Mailing Address - Phone:207-712-0308
Mailing Address - Fax:
Practice Address - Street 1:91 CAMDEN ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2455
Practice Address - Country:US
Practice Address - Phone:207-593-6682
Practice Address - Fax:207-593-7149
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3324225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist