Provider Demographics
NPI:1427488915
Name:FLOYD, STEPHANIE CLAIRE
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CLAIRE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:CLAIRE
Other - Last Name:REITEMEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5700 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53129-1442
Mailing Address - Country:US
Mailing Address - Phone:414-235-9170
Mailing Address - Fax:414-235-9417
Practice Address - Street 1:5700 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:GREENDALE
Practice Address - State:WI
Practice Address - Zip Code:53129-1442
Practice Address - Country:US
Practice Address - Phone:414-235-9170
Practice Address - Fax:414-235-9417
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5408-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist