Individual
MRS. STACY MARIE STUCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
907 E CENTRAL ST, UNION CITY, OH 45390-1605
(937) 968-5284
Mailing address
147 CHURCH ST, OSGOOD, OH 45351
(419) 852-7488
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
03718
OH
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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