Individual
TERESA STAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4501 WATERMAN WAY, TAVARES, FL 32778
(352) 460-2091
Mailing address
33405 WESLEY RD, EUSTIS, FL 32736-7227
(352) 460-2091
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16302
FL
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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