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General NPI Number Information
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NPI Number | 1346153509
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Entity Type | Individual
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Provider Name | INDRA STEPHENS
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Gender | Female
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 8550 ROUTE 29 STE 720
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City | FAIRFAX
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State | VA
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Zip | 22031-1531
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Country | US
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Telephone | 571-251-5523
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Fax |
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Provider Business Mailing Address
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Address Line | 7745 INVERSHAM DR APT 199
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City | FALLS CHURCH
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State | VA
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Zip | 22042-4454
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Country | US
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Telephone | 571-251-5523
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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 | 0019020884
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License Number State | VA
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