Provider Demographics
NPI:1063567089
Name:ERFLE, STACIE BYRD (OT)
Entity type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:BYRD
Last Name:ERFLE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8136 ROLLING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-9346
Mailing Address - Country:US
Mailing Address - Phone:406-600-3883
Mailing Address - Fax:
Practice Address - Street 1:11 W MAIN ST
Practice Address - Street 2:SUITE 218
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3700
Practice Address - Country:US
Practice Address - Phone:406-388-4988
Practice Address - Fax:406-388-6188
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT662840OtherBCBS