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Individual

MS. REGINA LEA STOLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR, CHT

Contact information

Practice address
900 PROFESSIONAL PARK DR, CLARKSVILLE, TN 37040-5244
(931) 648-8185
Mailing address
1881 PARDUE DR, CLARKSVILLE, TN 37043-4618

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31002495A
IN
225X00000X
Occupational Therapist
Primary
415388
TN

Other

Enumeration date
01/11/2012
Last updated
01/11/2012
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