Healthcare Provider Details

I. General information

NPI: 1063339448
Provider Name (Legal Business Name): CALLIE MARIE STONEKING OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 MAIN ST
BATTLE GROUND IN
47920-9757
US

IV. Provider business mailing address

4719 ELIJAH ST
WEST LAFAYETTE IN
47906-8733
US

V. Phone/Fax

Practice location:
  • Phone: 765-567-2200
  • Fax:
Mailing address:
  • Phone: 765-720-0458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31006031A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: