Individual
MS. STACY ANNE ROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
95 LAUREL ST, GREENFIELD, MA 01301-3106
(413) 774-3415
Mailing address
79 MONTAGUE CITY RD, GREENFIELD, MA 01301-3906
(413) 774-4240
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2872
MA
Other
Enumeration date
12/23/2006
Last updated
07/08/2007
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