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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

STACY J GARDNER, OT

Active

STACY J GARDNER, OT is a Pediatric Occupational Therapist healthcare provider located in SHELLEY, Idaho. NPI 1669239133 is currently active in the NPPES registry. Verify at CMS.

Pediatric Occupational Therapist · SHELLEY, ID

Registration Details

NPI Number
1669239133
Provider Type
Individual
Gender
Female
NPI Issued
Mar 1, 2024 (2.4123953413722 yrs)
Last Updated
Mar 1, 2024
License
OT988 (ID)

Practice Information

Address
650 N STATE ST STE 5
SHELLEY, ID, 832744900
Browse ID providers · Browse ZIP 83274
Phone
2084286079
Primary Specialty
Pediatric Occupational Therapist
225XP0200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.