Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stacy J Gardner, OT

Individual provider Pediatric Occupational Therapist · NPI 1669239133

Stacy J Gardner, OT is a Pediatric Occupational Therapist in Shelley, Idaho. Licensed in Idaho. Registered with an NPI since 2024.

Licensed in
ID
In the registry since
2024
What do these letters mean?
OT — Occupational Therapist
Helps people regain the skills needed for daily living and work.

See every abbreviation used in this directory →

Practice location Address checks out

650 N State St Ste 5
Shelley, ID 83274-4900
Phone: (208) 428-6079
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence OT988 (ID)

Record details

NPI number1669239133
Entity typeIndividual (Type 1)
GenderFemale
Credentials OT
Sole proprietorNo
NPI enumeratedMarch 1, 2024
Last updated in NPPESMarch 1, 2024
Certification dateMarch 1, 2024