Healthcare Provider Details

I. General information

NPI: 1225844327
Provider Name (Legal Business Name): STEPHANIE RHODES MILLER M.AC., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15920 LUANNE DR
GAITHERSBURG MD
20877-1408
US

IV. Provider business mailing address

15920 LUANNE DR
GAITHERSBURG MD
20877-1408
US

V. Phone/Fax

Practice location:
  • Phone: 410-804-1765
  • Fax:
Mailing address:
  • Phone: 410-804-1765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU03164
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: