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Individual

JONATHAN SCOTT STADLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7 MEADOWLARK LN, EAST LYME, CT 06333-1335
(860) 625-4799
Mailing address
7 MEADOWLARK LN, EAST LYME, CT 06333-1335
(860) 625-4799

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
4463
CT
225X00000X
Occupational Therapist
Primary
4463
CT

Other

Enumeration date
04/15/2019
Last updated
04/15/2019
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