Provider Demographics
NPI:1487955050
Name:STEPHENSON, SHERRI MARIE (OTR)
Entity type:Individual
Prefix:MR
First Name:SHERRI
Middle Name:MARIE
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9143 ROSEMARIE ROAD
Mailing Address - Street 2:
Mailing Address - City:REMSEN
Mailing Address - State:NY
Mailing Address - Zip Code:13438
Mailing Address - Country:US
Mailing Address - Phone:508-958-9484
Mailing Address - Fax:
Practice Address - Street 1:9143 ROSEMARIE RD
Practice Address - Street 2:
Practice Address - City:REMSEN
Practice Address - State:NY
Practice Address - Zip Code:13438-4451
Practice Address - Country:US
Practice Address - Phone:508-958-9484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63007435225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist