Individual
STACEY GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
25 RIDGEWOOD RD, BEDFORD, NH 03110-6510
(603) 222-0300
Mailing address
25 BIRCH RIDGE TRL, NASHUA, NH 03062-1229
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0659
NH
Other
Enumeration date
03/07/2014
Last updated
03/07/2014
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