Individual
STACEY M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11840 COMMONWEALTH DR, LOUISVILLE, KY 40299-2309
(502) 633-1007
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 633-1007
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
174700
KY
225XP0200X
Pediatric Occupational Therapist
174700
KY
Other
Enumeration date
11/08/2017
Last updated
12/12/2022
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