Provider Demographics
NPI:1215536859
Name:SCHMITT, STEPHANIE A (COTA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 W MARY LN
Mailing Address - Street 2:
Mailing Address - City:WATERFORD WORKS
Mailing Address - State:NJ
Mailing Address - Zip Code:08089-2401
Mailing Address - Country:US
Mailing Address - Phone:609-319-2176
Mailing Address - Fax:
Practice Address - Street 1:31 W MARY LN
Practice Address - Street 2:
Practice Address - City:WATERFORD WORKS
Practice Address - State:NJ
Practice Address - Zip Code:08089-2401
Practice Address - Country:US
Practice Address - Phone:609-319-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09201000224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant