Provider Demographics
NPI:1316265754
Name:STABILE, LAURIE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:
Last Name:STABILE
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 1:328 BARRINGTON SQUARE EST
Mailing Address - Street 2:UNIT A
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4154
Mailing Address - Country:US
Mailing Address - Phone:314-910-0607
Mailing Address - Fax:
Practice Address - Street 1:324 JUNGERMANN RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5350
Practice Address - Country:US
Practice Address - Phone:636-928-5327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003000850225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics