Individual
STEPHANIE LYNN MAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1026 NE 57TH LN, ANKENY, IA 50021-6919
(712) 210-6864
Mailing address
1026 NE 57TH LN, ANKENY, IA 50021-6919
(712) 210-6864
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
106005
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106005
COTA LICENSE
IA
Enumeration date
10/23/2020
Last updated
10/23/2020
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