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General NPI Number Information
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NPI Number | 1023870086
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Entity Type | Individual
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Provider Name | SARA DI STEFANO LMT, MTI, CEP
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Gender | Female
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 16607 BLANCO RD STE 1304
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City | SAN ANTONIO
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State | TX
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Zip | 78232-1913
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Country | US
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Telephone | 210-679-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 7604 LINKLEA
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City | SAN ANTONIO
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State | TX
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Zip | 78240-3022
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Country | US
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Telephone | 718-715-9722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT129721
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License Number State | TX
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