Individual
STACY MARIE EARL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
516 23RD AVE SE, PUYALLUP, WA 98372-4659
(253) 845-6631
Mailing address
7902 192ND AVE E, BONNEY LAKE, WA 98391-8554
(253) 720-2618
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60313173
WA
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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