Provider Demographics
NPI:1245881226
Name:PERKINSON, STEFANIA (LMT)
Entity type:Individual
Prefix:
First Name:STEFANIA
Middle Name:
Last Name:PERKINSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11002 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2413
Mailing Address - Country:US
Mailing Address - Phone:216-227-8668
Mailing Address - Fax:888-420-0239
Practice Address - Street 1:11002 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2413
Practice Address - Country:US
Practice Address - Phone:216-227-8668
Practice Address - Fax:888-420-0239
Is Sole Proprietor?:No
Enumeration Date:2019-09-22
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.019391225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist