Provider Demographics
NPI:1649489873
Name:MILTON-SMITH, STEPHANIE CARMILA (PT)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CARMILA
Last Name:MILTON-SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:MILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12605 PRINCES CHOICE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3399
Mailing Address - Country:US
Mailing Address - Phone:301-805-7768
Mailing Address - Fax:
Practice Address - Street 1:10301 GEORGIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-593-7300
Practice Address - Fax:301-593-1559
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist