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General NPI Number Information
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NPI Number | 1588433130
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Entity Type | Individual
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Provider Name | STEPHANIE MAYHEW
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Gender | Female
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Dates
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Enumeration Date | 12/22/2023
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 8106 FRYTOWN RD
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City | WARRENTON
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State | VA
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Zip | 20187-4331
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Country | US
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Telephone | 301-418-4258
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Fax | 540-935-2296
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Provider Business Mailing Address
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Address Line | 8106 FRYTOWN RD
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City | WARRENTON
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State | VA
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Zip | 20187-4331
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Country | US
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Telephone | 301-418-4258
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Fax | 540-935-2296
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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 | 0019008158
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License Number State | VA
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