Healthcare Provider Details

I. General information

NPI: 1477864759
Provider Name (Legal Business Name): GINA KAY STANGO OTR, OTD, MOT, ATP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2808 LONGHORN BLVD STE 308
AUSTIN TX
78758-7626
US

IV. Provider business mailing address

2808 LONGHORN BLVD STE 308
AUSTIN TX
78758-7626
US

V. Phone/Fax

Practice location:
  • Phone: 726-248-0701
  • Fax:
Mailing address:
  • Phone: 726-248-0701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225CA2500X
TaxonomyAssistive Technology Supplier Rehabilitation Counselor
License Number88344
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number117519
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: