Provider Demographics
NPI:1316659196
Name:SEGATTI, STEPHANY JEANNE (CTRS)
Entity type:Individual
Prefix:MRS
First Name:STEPHANY
Middle Name:JEANNE
Last Name:SEGATTI
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:STEPHANY
Other - Middle Name:JEANNE
Other - Last Name:LAFLAMME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CTRS
Mailing Address - Street 1:34154 EVERGREEN HILL CT
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-2125
Mailing Address - Country:US
Mailing Address - Phone:919-738-3055
Mailing Address - Fax:
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-450-4674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225800000X
58948225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
58948OtherNATIONAL COUNCIL FOR THERAPEUTIC RECREATION CERTIFICATION (NCTRC)