Individual
MRS. STACIE SELFRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
30 NORTHAMPTON STREET, BOSTON, MA 02118-4010
(617) 433-9601
(617) 445-6538
Mailing address
30 NORTHAMPTON STREET, BOSTON, MA 02118-4010
(617) 433-9601
(617) 445-6538
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11033
MA
Other
Enumeration date
04/21/2014
Last updated
10/22/2015
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