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Individual

MS. STEPHANIE RAE DIONISIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2611 JONES AVE, PUEBLO, CO 81004-2650
(719) 564-1735
Mailing address
426 JEFFERSON ST, PUEBLO, CO 81004-2320
(719) 320-7452

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0000082
CO

Other

Enumeration date
08/29/2018
Last updated
08/29/2018
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