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Individual

MRS. STACY A MCDONALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1820 SHORE DR S, SOUTH PASADENA, FL 33707-4601
(727) 851-9806
Mailing address
PO BOX 66724, ST PETE BEACH, FL 33736-6724
(386) 852-8210

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12159
FL

Other

Enumeration date
03/02/2012
Last updated
04/19/2016
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