Individual
STACI BORDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
633 MILL WOOD BLVD, MARYSVILLE, OH 43040-9339
(937) 578-6900
Mailing address
633 MILL WOOD BLVD, MARYSVILLE, OH 43040-9339
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08258
—
OH
Enumeration date
07/30/2009
Last updated
12/06/2023
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