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Individual
MATTHEW S STANGER
Active
Individual
MATTHEW S STANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1936
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT-1936
STATE LICENSE
ID
Enumeration date
07/16/2018
Last updated
07/16/2018
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