Provider Demographics
NPI:1104549914
Name:WERKHEISER, STEPHANIE (OTR/L)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WERKHEISER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 NE 37TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909
Mailing Address - Country:US
Mailing Address - Phone:302-358-1154
Mailing Address - Fax:
Practice Address - Street 1:2525 FIRST ST
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-2465
Practice Address - Country:US
Practice Address - Phone:302-358-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT22260225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist