Individual
STEPHANIE ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16880 W IVANHOE, MONTGOMERY, TX 77316-6729
(936) 648-7673
Mailing address
16880 W IVANHOE, MONTGOMERY, TX 77316-6729
(936) 648-7673
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
218178
TX
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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