Individual
MRS. STEPHANIE SNYDER HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2000 SALEMTOWNE DR, WINSTON SALEM, NC 27106-3488
(336) 776-2300
Mailing address
381 CARRIAGE TRACE LN, LEXINGTON, NC 27295-5372
(336) 853-7146
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5484
NC
Other
Enumeration date
04/10/2012
Last updated
04/10/2012
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