Individual
MRS. STACY MICHELLE SIZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
329 TOWNEPARK CIR, 100, LOUISVILLE, KY 40243-2348
(502) 254-9524
Mailing address
155 TOY CT, LOUISVILLE, KY 40229-6031
(502) 955-5086
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R3019
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KYR3019
STATE LICENSURE
KY
Enumeration date
11/22/2006
Last updated
07/08/2007
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