Individual
MRS. HOLLY SUZANNE STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
5499 W STATE ROUTE 68, LYNNVILLE, IN 47619-8225
(812) 449-3944
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001307A
IN
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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