Individual
MS. STACEY A HUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA-L
Contact information
Practice address
14441 KEDVALE AVE, MIDLOTHIAN, IL 60445-2716
(773) 728-8718
Mailing address
14441 KEDVALE AVE, MIDLOTHIAN, IL 60445-2716
(773) 728-8718
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004216
IL
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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