Provider Demographics
NPI:1528284213
Name:STIERS, DENISE KAY (OT)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:KAY
Last Name:STIERS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:DENISE
Other - Middle Name:KAY
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21600 S WESTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HARTSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:65039-9234
Mailing Address - Country:US
Mailing Address - Phone:573-635-4739
Mailing Address - Fax:
Practice Address - Street 1:1115 FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5443
Practice Address - Country:US
Practice Address - Phone:573-634-3070
Practice Address - Fax:573-636-3247
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000175701225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist