Provider Demographics
NPI:1871697326
Name:FAUSZ, STEPHANIE ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:FAUSZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3061 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3238
Mailing Address - Country:US
Mailing Address - Phone:859-331-3359
Mailing Address - Fax:
Practice Address - Street 1:2300 MONTANA AVENUE
Practice Address - Street 2:SUITE 420
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-3888
Practice Address - Country:US
Practice Address - Phone:513-662-3400
Practice Address - Fax:513-662-3071
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-03476225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist