Individual
STACY E OUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CAMPUS DR, WENTZVILLE, MO 63385-3415
(636) 327-3800
(636) 327-8611
Mailing address
601 CARR ST, WENTZVILLE, MO 63385-1151
(636) 327-3800
(636) 327-8611
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004320
MO
Other
Enumeration date
08/14/2008
Last updated
08/14/2008
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