Provider Demographics
NPI:1952811127
Name:STANTON, KAREN JEANNE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JEANNE
Last Name:STANTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SE CALMOSO DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2156
Mailing Address - Country:US
Mailing Address - Phone:772-985-3277
Mailing Address - Fax:
Practice Address - Street 1:170 SE CALMOSO DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2156
Practice Address - Country:US
Practice Address - Phone:772-985-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant