Provider Demographics
NPI:1225781750
Name:REXROAD, STEPHENIE MEIXING YI
Entity type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:MEIXING YI
Last Name:REXROAD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2093 HENRY TECKLENBURG DR STE 200E
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5742
Mailing Address - Country:US
Mailing Address - Phone:843-402-3114
Mailing Address - Fax:
Practice Address - Street 1:35 CROSSCREEK DR APT B2
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2509
Practice Address - Country:US
Practice Address - Phone:304-203-9607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer