Provider Demographics
NPI:1336226620
Name:SABOL, STEPHANIE E (MPT)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:E
Last Name:SABOL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14435 CHERRY LANE CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4959
Mailing Address - Country:US
Mailing Address - Phone:301-776-3665
Mailing Address - Fax:301-776-6669
Practice Address - Street 1:14435 CHERRY LANE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4959
Practice Address - Country:US
Practice Address - Phone:301-776-3665
Practice Address - Fax:301-776-6669
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD20953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01087OtherGROUP NUMBER
MDG01087OtherGROUP NUMBER
MDQ34841Medicare UPIN