Provider Demographics
NPI:1710161369
Name:WEILNAU, STEPHANIE J (OTR)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:J
Last Name:WEILNAU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:J
Other - Last Name:TURNBULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:250 INTERNATIONAL PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5030
Mailing Address - Country:US
Mailing Address - Phone:800-806-6026
Mailing Address - Fax:
Practice Address - Street 1:250 INTERNATIONAL PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-5030
Practice Address - Country:US
Practice Address - Phone:800-806-6026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1712225X00000X
TX111670225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist