Individual
STACI WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
415 QUAY ST, PORT HURON, MI 48060-3829
(810) 966-3480
Mailing address
415 QUAY ST, PORT HURON, MI 48060-3829
(810) 966-3480
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
520100667
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871542100
—
MI
Enumeration date
01/11/2019
Last updated
01/11/2019
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