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Individual

MS. STACY STANLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
4812 MOORE RD, SALEM, VA 24153
(540) 392-1711
Mailing address
4812 MOORE RD, SALEM, VA 24153-8080
(540) 392-1711

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001206
VA

Other

Enumeration date
08/28/2013
Last updated
06/06/2018
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