Provider Demographics
NPI:1669942264
Name:SANCHEZ-PADRON, STHEPHANIE ALEXANDRA (MS, LAT, ATC)
Entity type:Individual
Prefix:MISS
First Name:STHEPHANIE
Middle Name:ALEXANDRA
Last Name:SANCHEZ-PADRON
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 ENCHANTED PKWY APT 1
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5481
Mailing Address - Country:US
Mailing Address - Phone:402-591-9582
Mailing Address - Fax:
Practice Address - Street 1:203 ENCHANTED PKWY APT 1
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-5481
Practice Address - Country:US
Practice Address - Phone:402-591-9582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2021-09-14
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