Provider Demographics
NPI:1053992453
Name:ROWICKI, STACY (OTR)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:ROWICKI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:SEIBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:722 CAVAN DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-8339
Mailing Address - Country:US
Mailing Address - Phone:412-607-3780
Mailing Address - Fax:
Practice Address - Street 1:201 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2345
Practice Address - Country:US
Practice Address - Phone:407-530-5063
Practice Address - Fax:877-399-5570
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT13251225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist