Individual
STACY CUDDEBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2317 HAMPDEN BLVD, READING, PA 19604-1004
(484) 638-1023
Mailing address
2317 HAMPDEN BLVD, READING, PA 19604-1004
(484) 638-1023
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP00001985L
PA
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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