MEDICARE: JENNIFER STEPHENS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	M07175	MD

General Provider Information

NPI Number	:	1639004476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER STEPHENS

Provider Business Mailing Address
First Line	:	616 PLYMOUTH RD # 2
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21229-2212
Country	:	US
Telephone Number	:	410-916-2479
Fax Number	:

Provider Business Practice Location Address
First Line	:	9256 BENDIX RD STE 200B
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-1848
Country	:	US
Telephone Number	:	443-648-9095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ JENNIFER STEPHENS ” Practice Location

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