Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 16283 | FL |
NPI | 1114338209 |
---|---|
Provider Name | Mrs. Stephanie Carol Fischette |
First Address | Saint Petersburg, FL 33710-7416 |
Second Address | South Pasadena, FL 33707-4601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2014 |
Last Update Date | 12/05/2014 |