Provider Demographics
NPI:1376712711
Name:COWLES, STEPHANIE MAY (CMT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MAY
Last Name:COWLES
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 MISSION ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2467
Mailing Address - Country:US
Mailing Address - Phone:415-282-8989
Mailing Address - Fax:415-920-0205
Practice Address - Street 1:2460 MISSION ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2467
Practice Address - Country:US
Practice Address - Phone:415-282-8989
Practice Address - Fax:415-920-0205
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA703240225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist