Individual
STACEY LINN ANDRADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(855) 477-5627
Mailing address
22 MANCHESTER DR, WILKES BARRE, PA 18702-7315
(570) 569-2311
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP009661
PA
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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