Provider Demographics
NPI:1215450127
Name:BATES, STEPHANIE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:DIONNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MECHANIC FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04256-6346
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:440 MINOT AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-4332
Practice Address - Country:US
Practice Address - Phone:207-784-3573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-23
Last Update Date:2017-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant