Individual
STACIE LYNN BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
12101 LIESFELD FARM DR, GLEN ALLEN, VA 23059-7097
(804) 364-0055
Mailing address
4611 EMMETT RD, GLEN ALLEN, VA 23060-3537
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003887
VA
Other
Enumeration date
01/16/2018
Last updated
01/16/2018
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