Individual
STACIE NICOLE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.D.
Contact information
Practice address
248 CAMPGROUND RD, LIVINGSTON, TN 38570-8920
(931) 252-3851
Mailing address
248 CAMPGROUND RD, LIVINGSTON, TN 38570-8920
(931) 252-3851
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4031
TN
Other
Enumeration date
07/31/2009
Last updated
08/12/2009
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