Individual
STACEY BORODKIN WAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9 ELMWOOD CT, NEWINGTON, CT 06111-1401
(860) 953-1204
Mailing address
9 ELMWOOD CT, NEWINGTON, CT 06111-1401
(860) 953-1204
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2991
CT
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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