Individual
STEPHANIE MALLORY SIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1213 W STRATFORD RD, AVON PARK, FL 33825-8091
(863) 399-2332
Mailing address
4 FOREST HILL DR, AVON PARK, FL 33825-4220
(863) 399-2332
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11373
FL
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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