Provider Demographics
NPI:1154875680
Name:LEFEVERS, STEPHENIE
Entity type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:
Last Name:LEFEVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 OAK BEND DR
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-5338
Mailing Address - Country:US
Mailing Address - Phone:972-259-7179
Mailing Address - Fax:
Practice Address - Street 1:724 E US HIGHWAY 80 STE 200
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-8720
Practice Address - Country:US
Practice Address - Phone:972-259-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-13
Last Update Date:2016-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119095225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist