Provider Demographics
NPI:1154731479
Name:SCHOFIELD, STACEY LYNN (MS, ATC, LAT, CSCS)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:LYNN
Last Name:SCHOFIELD
Suffix:
Gender:F
Credentials:MS, ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-6003
Mailing Address - Country:US
Mailing Address - Phone:860-805-2435
Mailing Address - Fax:
Practice Address - Street 1:49 CAPUTO RD
Practice Address - Street 2:
Practice Address - City:NORTH BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06471-1028
Practice Address - Country:US
Practice Address - Phone:860-805-2435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0004582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer