Individual
AMANDA NICOLE STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
870 OAK MEADOW DR, FRANKLIN, TN 37064
(615) 721-5439
Mailing address
9101 WESLEYAN RD STE 100, INDIANAPOLIS, IN 46268-3103
(800) 603-6046
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3077
ME
Other
Enumeration date
10/05/2015
Last updated
06/05/2019
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