Basic Information
Provider Information
NPI: 1215664073
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARNOLD
FirstName: STEPHANIE
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential: BS, ATC, LAT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 UNIVERSITY DR # MCA410
Address2:  
City: HERSHEY
State: PA
PostalCode: 170332360
CountryCode: US
TelephoneNumber: 8002431455
FaxNumber:  
Practice Location
Address1: 30 HOPE DR
Address2:  
City: HERSHEY
State: PA
PostalCode: 170332036
CountryCode: US
TelephoneNumber: 7175317414
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/02/2022
LastUpdateDate: 08/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2255A2300XRT007633PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer

No ID Information.


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