Provider Demographics
NPI:1891394680
Name:STEPHENSON, RACHEL ANN (DPT)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANN
Last Name:STEPHENSON
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 1:3015 N SCOTTSDALE RD UNIT 2118
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7249
Mailing Address - Country:US
Mailing Address - Phone:716-574-7457
Mailing Address - Fax:
Practice Address - Street 1:7525 E BROADWAY RD STE 6
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-1156
Practice Address - Country:US
Practice Address - Phone:480-354-2911
Practice Address - Fax:480-984-3169
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NY046361225100000X
MTLPT-31521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist