Individual
MRS. STACIE PORTER BERCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
3057 LORNA RD, BIRMINGHAM, AL 35216-4514
(205) 978-9939
Mailing address
1326 NARROWS POINT BND, BIRMINGHAM, AL 35242-8676
(205) 980-0393
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2465
AL
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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