Provider Demographics
NPI:1841640117
Name:GAUQUIER, STEFANIE (MS, ATC)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:GAUQUIER
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 BLUFFTON PKWY
Mailing Address - Street 2:#1534
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4610
Mailing Address - Country:US
Mailing Address - Phone:603-733-7556
Mailing Address - Fax:
Practice Address - Street 1:95 MATHEWS DR
Practice Address - Street 2:SUITE D5
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-3734
Practice Address - Country:US
Practice Address - Phone:603-733-7556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer