Provider Demographics
NPI:1871717298
Name:LE, STEPHANIE THU (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:THU
Last Name:LE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:18625 SHERMAN WAY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4191
Mailing Address - Country:US
Mailing Address - Phone:818-345-0999
Mailing Address - Fax:818-345-6787
Practice Address - Street 1:18625 SHERMAN WAY
Practice Address - Street 2:SUITE 109
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4191
Practice Address - Country:US
Practice Address - Phone:818-345-0999
Practice Address - Fax:818-345-6787
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC21035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor