Provider Demographics
NPI:1447228168
Name:DENNER, STEPHANIE LYNN (OTR)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:DENNER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:DOBKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:47085 GRATIOT
Mailing Address - Street 2:
Mailing Address - City:CETERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051
Mailing Address - Country:US
Mailing Address - Phone:586-598-1247
Mailing Address - Fax:586-598-1260
Practice Address - Street 1:47085 GRATIOT
Practice Address - Street 2:
Practice Address - City:CETERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051
Practice Address - Country:US
Practice Address - Phone:586-598-1247
Practice Address - Fax:586-598-1260
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006845225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist