Individual
MRS. STACY A PELLETIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1604 N MAIN ST, SUITE C, MOUNTAIN GROVE, MO 65711-1010
(417) 926-6563
(417) 926-1502
Mailing address
108 N INGRAHAM ST, NORWOOD, MO 65717-9653
(417) 746-0181
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2007032812
MO
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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