Provider Demographics
NPI:1396799789
Name:VILHAUER, STACEY A (MS OTR/L)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:A
Last Name:VILHAUER
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:A
Other - Last Name:GIBLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:414 10TH ST. SOUTH
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401
Mailing Address - Country:US
Mailing Address - Phone:320-839-4087
Mailing Address - Fax:320-839-4196
Practice Address - Street 1:414 10TH ST. SOUTH
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401
Practice Address - Country:US
Practice Address - Phone:605-725-7200
Practice Address - Fax:605-725-7299
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103316225X00000X
SD0649225X00000X
NV0782225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist