MEDICARE: STEFANIE K SILVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT-2024-0127	NM

General Provider Information

NPI Number	:	1932938958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIE K SILVA

Provider Business Mailing Address
First Line	:	724 W ANIMAS ST
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-5617
Country	:	US
Telephone Number	:	505-215-9042
Fax Number	:

Provider Business Practice Location Address
First Line	:	724 W ANIMAS ST
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-5617
Country	:	US
Telephone Number	:	505-215-9042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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Directions to “ STEFANIE K SILVA ” Practice Location

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