Individual
WINIFRED STACY LOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
7540 N 19TH AVE STE 200, PHOENIX, AZ 85021-7967
(888) 873-4221
Mailing address
4 HARBOR RD, DARIEN, CT 06820-5809
(203) 655-0686
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
50
CT
Other
Enumeration date
09/03/2007
Last updated
09/03/2007
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