Individual
STACEY DAWN SVETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
11253361
TN
224Z00000X
Occupational Therapy Assistant
Primary
11253371
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11253361
TENNESSEE STATE LICENSE
TN
Enumeration date
12/10/2018
Last updated
12/10/2018
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