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General NPI Number Information
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NPI Number | 1235483496
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Entity Type | Individual
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Provider Name | STEPHANIE ALLEN OTR
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Gender | Female
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 6913 FALLING MEADOWS DR
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City | GALENA
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State | OH
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Zip | 43021-7502
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Country | US
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Telephone | 614-581-3277
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 152
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City | SUNBURY
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State | OH
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Zip | 43074-0152
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Country | US
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Telephone | 614-581-3277
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | #05155
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT010890
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License Number State | OH
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