Individual
MICHELLE STAAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 DUNSFORD CT, WALKERSVILLE, MD 21793-8247
(240) 446-2249
Mailing address
102 DUNSFORD CT, WALKERSVILLE, MD 21793-8247
(240) 446-2249
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02107
MD
224Z00000X
Occupational Therapy Assistant
C2100
WV
Other
Enumeration date
03/04/2017
Last updated
03/04/2017
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