Provider Demographics
NPI:1215301593
Name:BLAUVELT, STEPHANIE JANE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JANE
Last Name:BLAUVELT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:JANE
Other - Last Name:PELLETIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:20 MILLERS FARM DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03868-8830
Mailing Address - Country:US
Mailing Address - Phone:603-630-2407
Mailing Address - Fax:
Practice Address - Street 1:40 WHITEHALL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3225
Practice Address - Country:US
Practice Address - Phone:603-332-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-24
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2352225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist