Provider Demographics
NPI:1215007828
Name:STASIK, KARLIE ANNE (OT)
Entity Type:Individual
Prefix:MS
First Name:KARLIE
Middle Name:ANNE
Last Name:STASIK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:KARLIE
Other - Middle Name:STASIK
Other - Last Name:GAWNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:1174 HERON CT
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2053
Mailing Address - Country:US
Mailing Address - Phone:717-737-1457
Mailing Address - Fax:
Practice Address - Street 1:5225 WILSON LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6663
Practice Address - Country:US
Practice Address - Phone:717-591-8063
Practice Address - Fax:717-697-6576
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008104225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist