Healthcare Provider Details
I. General information
NPI: 1881693299
Provider Name (Legal Business Name): STEPHANIE KAY BEAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/18/2005
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7465 LANCASTER PIKE BLDG 1
HOCKESSIN DE
19707-9583
US
IV. Provider business mailing address
322 ELIOT CIR
COATESVILLE PA
19320-2576
US
V. Phone/Fax
- Phone: 302-234-4261
- Fax: 302-239-7306
- Phone: 610-383-0331
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 006755L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | J1-0002976 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: