Individual
MISS SUSAN GAYE STAYNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1528 PATRICIA AVE, APT. # 162, SIMI VALLEY, CA 93065-3491
(951) 255-0777
Mailing address
103 ORION PL, CHEHALIS, WA 98532-9021
(360) 748-3550
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC00000867
WA
224Z00000X
Occupational Therapy Assistant
OTA676
CA
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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