Provider Demographics
NPI:1184930620
Name:POTTS, STEPHANIE ML (OTD, MOTR/L, CFMP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ML
Last Name:POTTS
Suffix:
Gender:F
Credentials:OTD, MOTR/L, CFMP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:LANGFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:222 MARINERS WAY
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2290
Mailing Address - Country:US
Mailing Address - Phone:302-593-9986
Mailing Address - Fax:302-593-9986
Practice Address - Street 1:222 MARINERS WAY
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2290
Practice Address - Country:US
Practice Address - Phone:302-593-9986
Practice Address - Fax:302-593-9986
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-22
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0001047225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist