Individual
MRS. HOLLY STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
40 DOUGLAS AVE NW, ROANOKE, VA 24012-4611
(540) 853-2502
Mailing address
1816 CONNORS RUN, SALEM, VA 24153-7439
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119002952
VA
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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