Provider Demographics
NPI:1104690783
Name:FOLLETTE, STEPHANIE (DPT, GCS)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:FOLLETTE
Suffix:
Gender:F
Credentials:DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 TWITCHGRASS RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4636
Mailing Address - Country:US
Mailing Address - Phone:203-554-1349
Mailing Address - Fax:
Practice Address - Street 1:400 MILL PLAIN RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5048
Practice Address - Country:US
Practice Address - Phone:203-255-3573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0090142251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics