Provider Demographics
NPI:1760856488
Name:ALLEN, STEPHANIE W (DPT)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:W
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:OSPT SOUTH OFFICE 4470 REGENCY PLACE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695
Mailing Address - Country:US
Mailing Address - Phone:301-934-0498
Mailing Address - Fax:
Practice Address - Street 1:OSPT SOUTH OFFICE 4470 REGENCY PLACE
Practice Address - Street 2:SUITE #100
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695
Practice Address - Country:US
Practice Address - Phone:301-934-0498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist