Individual
STACIE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 S 17TH ST, STE 101, WILMINGTON, NC 28401-6628
(910) 763-8184
Mailing address
907 BALA LN, WILMINGTON, NC 28409-4951
(310) 392-5784
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3729
LICENSE #
NC
Enumeration date
08/21/2006
Last updated
07/08/2007
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