Individual
MRS. KELLI DAWN STANCOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
429 S MARKET ST, MARTINSBURG, PA 16662-1005
(814) 793-5206
(814) 793-3818
Mailing address
179 HEMLOCK DR, PORTAGE, PA 15946-2041
(814) 736-9536
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC008172
PA
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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