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Individual

STACEY A MCIVOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
18 HIGH RISE RD, DANBURY, CT 06811-3836
(203) 739-5752
Mailing address
121 CODFISH HILL RD, BETHEL, CT 06801-3203
(475) 279-0347

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003957
CT

Other

Enumeration date
09/19/2013
Last updated
06/11/2020
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