Provider Demographics
NPI:1164419735
Name:STROUSE, STEPHANIE DAWN (OTR/L)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DAWN
Last Name:STROUSE
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 1:219 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-4431
Mailing Address - Country:US
Mailing Address - Phone:570-668-1889
Mailing Address - Fax:570-668-6115
Practice Address - Street 1:219 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-4431
Practice Address - Country:US
Practice Address - Phone:570-668-1889
Practice Address - Fax:570-668-6115
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008620225X00000X
225XE1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
818779OtherFIRST PRIORITY HEALTH
1660739OtherHIGHMARK BLUE SHIELD
P00276070OtherRAILROAD MEDICARE
2001019OtherKEYSTONE
254293OtherHEALTH ASSURANCE
11360980OtherCAQH
7547629OtherAETNA PPO
2336610000OtherINDEPENDENCE BLUE CROSS
50044127OtherCAPITAL BLUE CROSS
3738457OtherAETNA HMO
P00276070OtherRAILROAD MEDICARE
11360980OtherCAQH