Provider Demographics
NPI:1336514405
Name:LEHRER, STACEY (MED, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:STACEY
Middle Name:
Last Name:LEHRER
Suffix:
Gender:F
Credentials:MED, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 PEABODY DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-1922
Mailing Address - Country:US
Mailing Address - Phone:401-368-7301
Mailing Address - Fax:
Practice Address - Street 1:60 PEABODY DR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-1922
Practice Address - Country:US
Practice Address - Phone:401-368-7301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01020225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist