Provider Demographics
NPI:1831930809
Name:HOUSEKNECHT, STEFANIE (PHARMD)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:HOUSEKNECHT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PINETREE CT
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-1646
Mailing Address - Country:US
Mailing Address - Phone:302-345-9381
Mailing Address - Fax:
Practice Address - Street 1:5505 HOPKINS BAYVIEW CIR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-6821
Practice Address - Country:US
Practice Address - Phone:443-401-3258
Practice Address - Fax:410-550-4595
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD250251835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology