Provider Demographics
NPI:1952701096
Name:MICHEL, STEPHANIE (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MICHEL
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 MACDADE BLVD
Mailing Address - Street 2:
Mailing Address - City:MILMONT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19033-3018
Mailing Address - Country:US
Mailing Address - Phone:610-772-5272
Mailing Address - Fax:
Practice Address - Street 1:4745 OGLETOWN STANTON RD STE 225
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1387
Practice Address - Country:US
Practice Address - Phone:302-731-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer