Individual
MS. STACEY L ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ASSOCIATES DEGREE
Contact information
Practice address
255 GROS BLVD, HERKIMER, NY 13350-1455
(315) 866-8562
Mailing address
PO BOX 381, NEW HARTFORD, NY 13413-0381
(315) 732-6911
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
001787-1
NY
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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