Individual
STACY ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2119 W SPRING ST, LIMA, OH 45805-2631
(419) 236-2574
Mailing address
2119 W SPRING ST, LIMA, OH 45805-2631
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
595
OH
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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