Individual
MISS STACY JO HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5002 SHERMAN HILL RD APT B, LARAMIE, WY 82070-5339
(307) 745-1410
(307) 742-9450
Mailing address
5002 SHERMAN HILL RD APT B, LARAMIE, WY 82070-5339
(307) 745-1410
(307) 742-9450
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
COTA-676
WY
Other
Enumeration date
07/16/2009
Last updated
07/16/2009
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