Provider Demographics
NPI:1285075622
Name:ARMSTRONG, STEPHANIE SUZANNE (MSOT, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:SUZANNE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:SUZANNE
Other - Last Name:HAEUSSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT, OTR/L
Mailing Address - Street 1:2378 WOODLAKE DR STE 280
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-6016
Mailing Address - Country:US
Mailing Address - Phone:517-706-0421
Mailing Address - Fax:
Practice Address - Street 1:2378 WOODLAKE DR STE 280
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864
Practice Address - Country:US
Practice Address - Phone:517-706-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5352-26225X00000X
MI5201008582225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist