Individual
STEPHANIE LEE HUMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2300 S OAK GROVE RD, ENNIS, TX 75119-6841
(972) 875-8643
Mailing address
2308 MEMPHIS ST, ENNIS, TX 75119-7349
(463) 285-6748
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210077
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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