Individual
STEPHANIE DISQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 LOG CANOE CIR, STEVENSVILLE, MD 21666-2128
(443) 203-8810
Mailing address
122 CHESAPEAKE ESTATES DR, STEVENSVILLE, MD 21666-2934
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M05167
MD
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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