Individual
STACYANN ELLEN SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
350 S RIDGEWOOD AVE, ORMOND BEACH, FL 32174-7028
(386) 677-4545
Mailing address
3500 HARBISON DRIVE APT. 202, VACAVILLE, CA 95768-9232
(707) 880-1291
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10091
FL
Other
Enumeration date
03/26/2007
Last updated
09/20/2017
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