Individual
MRS. STACEY A BRYHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7490 WALNUT AVE, PENNSAUKEN, NJ 08109-3077
(856) 839-1447
Mailing address
6101 N FALLS CIRCLE DR APT 109, LAUDERHILL, FL 33319-6841
(856) 839-1447
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15799
FL
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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