Individual
STACIA D SWEENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
701 N SARAH DEWITT DR, GONZALES, TX 78629-2813
(830) 672-4530
Mailing address
701 N SARAH DEWITT DR, GONZALES, TX 78629-2813
(830) 672-4530
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210176
TX
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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