Provider Demographics
NPI:1174650634
Name:COLEMAN, STEPHANIE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 CONNECTICUT AVE NW
Mailing Address - Street 2:STE. 301
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1111
Mailing Address - Country:US
Mailing Address - Phone:202-248-3044
Mailing Address - Fax:202-265-1111
Practice Address - Street 1:1555 CONNECTICUT AVE NW
Practice Address - Street 2:STE. 301
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1111
Practice Address - Country:US
Practice Address - Phone:202-248-3044
Practice Address - Fax:202-265-1111
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870740225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist