Provider Demographics
NPI:1831395169
Name:MAXFIELD, STEPHANIE N (PT, OCS)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:N
Last Name:MAXFIELD
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 SWANN ST NW APT B
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3999
Mailing Address - Country:US
Mailing Address - Phone:202-641-1600
Mailing Address - Fax:
Practice Address - Street 1:5165 11TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-3231
Practice Address - Country:US
Practice Address - Phone:703-933-0297
Practice Address - Fax:703-933-0697
Is Sole Proprietor?:No
Enumeration Date:2007-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203016174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist