Individual
MS. STACEY LYNNE WALSH I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4949 OGLETOWN STANTON RD, NEWARK, DE 19713-2068
(302) 998-6900
Mailing address
618 W 27TH ST, WILMINGTON, DE 19802-3466
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
U2-0000718
DE
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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