Provider Demographics
NPI:1457078719
Name:STAUFER, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:STAUFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3262 LULLABY LN
Mailing Address - Street 2:
Mailing Address - City:NEW FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44216-9310
Mailing Address - Country:US
Mailing Address - Phone:330-592-4115
Mailing Address - Fax:
Practice Address - Street 1:3262 LULLABY LN
Practice Address - Street 2:
Practice Address - City:NEW FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:44216-9310
Practice Address - Country:US
Practice Address - Phone:330-592-4115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant