Individual
MRS. MICHELLE STACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4304 E 205TH ST, BELTON, MO 64012-9237
(816) 509-6227
Mailing address
4304 E 205TH ST, BELTON, MO 64012-9237
(816) 509-6227
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2014027967
MO
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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