Provider Demographics
NPI:1962839126
Name:STOERMER, MICHELLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:STOERMER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BRADLEY CT
Mailing Address - Street 2:
Mailing Address - City:ELDRIDGE
Mailing Address - State:IA
Mailing Address - Zip Code:52748-9576
Mailing Address - Country:US
Mailing Address - Phone:513-290-3934
Mailing Address - Fax:
Practice Address - Street 1:11 BRADLEY CT
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748-9576
Practice Address - Country:US
Practice Address - Phone:513-290-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009730225X00000X
IA002062225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist