Individual
KELLY STAMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
301 CLEARFIELD AVE, CHESAPEAKE, VA 23320-4099
(757) 315-6900
Mailing address
2252 BARTHOLOMEWS XING # X-ING, VIRGINIA BEACH, VA 23456-5251
(757) 286-0975
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001308
VA
Other
Enumeration date
07/28/2018
Last updated
07/28/2018
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