Individual
VIRGINIA CHAVEZ STALLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1415 COUNTRY CLUB RD, MOUNT VERNON, IN 47620-9301
(812) 838-6554
Mailing address
801 E 5TH ST, MOUNT VERNON, IN 47620-2020
(812) 838-4185
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001434A
IN
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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