Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stacie L Wallace, MS, OTR/L

Individual provider Occupational Therapist · NPI 1568866788

Stacie L Wallace, MS, OTR/L is an Occupational Therapist in Bradenton, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2014
What do these letters mean?
MS — Master of Science
A graduate science degree.
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

3823 E State Road 64
Bradenton, FL 34208-9041
Phone: (941) 745-5111
Fax: (941) 745-5667
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT16654 (FL)

Record details

NPI number1568866788
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , OTR/L
Sole proprietorYes
NPI enumeratedOctober 17, 2014
Last updated in NPPESOctober 17, 2014

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