Provider Demographics
NPI:1720889298
Name:ROTHE VILLAVECES, STEPHANIE ANDREA (DPT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANDREA
Last Name:ROTHE VILLAVECES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6142 PARSLEY DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2664
Mailing Address - Country:US
Mailing Address - Phone:571-721-9311
Mailing Address - Fax:
Practice Address - Street 1:225 REINEKERS LN STE GR4
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2871
Practice Address - Country:US
Practice Address - Phone:703-299-3111
Practice Address - Fax:703-299-1556
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist