MEDICARE: MICHELLE STEPHENSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	2344	OH

General Provider Information

NPI Number	:	1477976678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE STEPHENSON

Provider Business Mailing Address
First Line	:	8050 HUGHES RD
Second Line	:
City	:	HOUSTON
State	:	OH
Zip	:	45333-9799
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8050 HUGHES RD
Second Line	:
City	:	HOUSTON
State	:	OH
Zip	:	45333-9799
Country	:	US
Telephone Number	:	937-493-0542
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2014
Last Update Date	:	01/24/2014

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Directions to “ MICHELLE STEPHENSON ” Practice Location

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