Provider Demographics
NPI:1144358771
Name:STEARNS, JANICE R (OTR L)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:R
Last Name:STEARNS
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW FRANKLIN
Mailing Address - State:MO
Mailing Address - Zip Code:65274-9602
Mailing Address - Country:US
Mailing Address - Phone:660-338-2012
Mailing Address - Fax:660-338-5999
Practice Address - Street 1:412 W BROADWAY
Practice Address - Street 2:NEW FRANKLIN R-I SCHOOL DISTRICT
Practice Address - City:NEW FRANKLIN
Practice Address - State:MO
Practice Address - Zip Code:65274-9602
Practice Address - Country:US
Practice Address - Phone:660-338-2012
Practice Address - Fax:660-338-5999
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000172225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO473668325Medicaid