Provider Demographics
NPI:1942768635
Name:FEATHERBY, STEPHANIE (OTR/L)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FEATHERBY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:BIRKMEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2242 STRAWBERRY FARM ST NE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49306-8809
Mailing Address - Country:US
Mailing Address - Phone:616-901-7795
Mailing Address - Fax:
Practice Address - Street 1:2242 STRAWBERRY FARM ST NE
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MI
Practice Address - Zip Code:49306-8809
Practice Address - Country:US
Practice Address - Phone:616-901-7795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119-008070225X00000X
MI5201013267225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist