Individual
STACEY PANICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4301 S FLAMINGO RD STE 101, DAVIE, FL 33330-1902
(954) 312-3449
Mailing address
15600 LANCE POINT PL, DAVIE, FL 33331-3332
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT25417
FL
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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