Individual
STACEY LYNETTE GUTHRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
70885 TWIN BEECH RD, BRIDGEPORT, OH 43912-7710
(740) 633-2353
(740) 633-2353
Mailing address
70885 TWIN BEECH RD, BRIDGEPORT, OH 43912-7710
(740) 633-2353
(740) 633-2353
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTA02733
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064
—
OH
Enumeration date
08/21/2014
Last updated
08/21/2014
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