Provider Demographics
NPI:1992103683
Name:CALABRACE, STEPHANIE BLAKELY (OT/L)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:BLAKELY
Last Name:CALABRACE
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MICHELE
Other - Last Name:BLAKELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT/L
Mailing Address - Street 1:211 COOL SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7242
Mailing Address - Country:US
Mailing Address - Phone:615-778-6834
Mailing Address - Fax:
Practice Address - Street 1:211 COOL SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-7242
Practice Address - Country:US
Practice Address - Phone:615-778-6834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology