Individual
STACIE MCMILLION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
404 GLADE ST, SHADY SPRING, WV 25918-9530
(304) 228-1525
Mailing address
304 DELRAY DR, SAINT ALBANS, WV 25177-3503
(304) 228-1525
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2051
WV
Other
Enumeration date
02/09/2016
Last updated
04/13/2022
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