Provider Demographics
NPI:1205512456
Name:STEPHENSON, INDIYAH CHELSEA (BS)
Entity type:Individual
Prefix:MS
First Name:INDIYAH
Middle Name:CHELSEA
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28244 LITTLE TEXAS RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23828-2000
Mailing Address - Country:US
Mailing Address - Phone:757-653-1934
Mailing Address - Fax:
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-4915
Practice Address - Country:US
Practice Address - Phone:804-675-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist