Individual
MRS. STEPHANIE MARIE RUDISILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1640 REDSTONE CENTER DR, SUITE 200, PARK CITY, UT 84098-7605
(214) 575-9820
(214) 575-9846
Mailing address
703 NORTHILL DR, RICHARDSON, TX 75080-5018
(972) 238-7192
(972) 238-7192
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109688
TX
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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