Individual
STACY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
120 N RICHARD JACKSON BLVD, SUITE 130, PANAMA CITY, FL 32407-2521
(850) 235-6360
(850) 235-8871
Mailing address
120 N RICHARD JACKSON BLVD, SUITE 130, PANAMA CITY, FL 32407-2521
(850) 235-6360
(850) 235-8871
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT0005631
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
885913200
—
FL
Enumeration date
07/10/2006
Last updated
07/02/2013
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