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General NPI Number Information
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NPI Number | 1508428475
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Entity Type | Individual
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Provider Name | STEPHANIE RAE GUFFEY RBT, BCAT, LMT, CNMT
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Gender | Female
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 6216 OLD KEENE MILL CT
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City | SPRINGFIELD
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State | VA
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Zip | 22152-2323
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Country | US
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Telephone | 571-297-4308
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Fax | 703-992-0405
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Provider Business Mailing Address
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Address Line | 6216 OLD KEENE MILL CT
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City | SPRINGFIELD
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State | VA
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Zip | 22152-2323
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Country | US
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Telephone | 571-297-4308
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Fax | 703-992-0405
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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 | 0019016638
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-140738
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License Number State | VA
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