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Individual

AMY STAFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1560
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13Y004021NH01
ANTHEM
NH
01
4126960
MVP HEALTHCARE
NH
Enumeration date
05/15/2007
Last updated
07/21/2022
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