Healthcare Provider Details

I. General information

NPI: 1700687209
Provider Name (Legal Business Name): HALLE STEPHENSON OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11225 DAVENPORT ST STE 100
OMAHA NE
68154-2641
US

IV. Provider business mailing address

1221 N 170TH ST SITE 231
OMAHA NE
68118-2922
US

V. Phone/Fax

Practice location:
  • Phone: 712-560-0240
  • Fax:
Mailing address:
  • Phone: 605-760-5997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: