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General NPI Number Information
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NPI Number | 1558233197
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Entity Type | Individual
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Provider Name | STEPHANIE REJEANA FAULKNER
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1110 S TALBOT ST STE 6
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City | ST MICHAELS
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State | MD
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Zip | 21663-2606
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Country | US
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Telephone | 443-695-9649
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Fax |
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Provider Business Mailing Address
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Address Line | 214 BROOKS LN
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City | ST MICHAELS
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State | MD
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Zip | 21663-2128
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Country | US
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Telephone | 443-525-8134
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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 | R03338
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License Number State | MD
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