Healthcare Provider Details

I. General information

NPI: 1356658280
Provider Name (Legal Business Name): ALEXA STEVENS MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 BUNKER HILL RD NE
WASHINGTON DC
20017-3026
US

IV. Provider business mailing address

1411 GIRARD ST NE
WASHINGTON DC
20017-2941
US

V. Phone/Fax

Practice location:
  • Phone: 202-635-6154
  • Fax:
Mailing address:
  • Phone: 202-415-4420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT870419
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: