Provider Demographics
NPI:1619211505
Name:KUNTZ, STEPHANIE DENEITH (MOT, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:DENEITH
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 TOWNE PARK DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-8365
Mailing Address - Country:US
Mailing Address - Phone:937-552-2487
Mailing Address - Fax:
Practice Address - Street 1:1840 TOWNE PARK DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-8365
Practice Address - Country:US
Practice Address - Phone:937-552-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT21241225X00000X
OHOT011239225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOTA.02362OtherOCCUPATIONAL THERAPY ASSISTANT