Provider Demographics
NPI:1730995143
Name:OBIA-AMAUWA, STEPHANIE ONYINYECHI (DPT)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ONYINYECHI
Last Name:OBIA-AMAUWA
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 1:4009 PEPPERTREE LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2586
Mailing Address - Country:US
Mailing Address - Phone:240-715-5404
Mailing Address - Fax:
Practice Address - Street 1:8380 COLESVILLE RD STE 400
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6263
Practice Address - Country:US
Practice Address - Phone:301-563-3081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist