Provider Demographics
NPI:1497158950
Name:ONLEY, STACIE
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:ONLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TERWILLEGERS RUN
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9253
Mailing Address - Country:US
Mailing Address - Phone:513-324-5141
Mailing Address - Fax:
Practice Address - Street 1:400 TERWILLEGERS RUN
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9253
Practice Address - Country:US
Practice Address - Phone:513-324-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.04235224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant