Provider Demographics
NPI:1568210250
Name:DUSKE, STEPHANIE (BS, COTA/L)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:DUSKE
Suffix:
Gender:F
Credentials:BS, COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 US HIGHWAY 12 SE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:MN
Mailing Address - Zip Code:55363-8013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1104 E RIVER ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-8762
Practice Address - Country:US
Practice Address - Phone:763-271-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant