Provider Demographics
NPI:1548488406
Name:STINDT, KAREN JACKSON (MS OTR)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JACKSON
Last Name:STINDT
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:FAIRWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53931-0111
Mailing Address - Country:US
Mailing Address - Phone:920-346-2796
Mailing Address - Fax:
Practice Address - Street 1:2300 STATE RD. 44
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54903-2568
Practice Address - Country:US
Practice Address - Phone:920-236-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1024026225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics