Individual
MS. CASEY GAIL STALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
11 DAIRY LN, FREDERICKSBURG, VA 22405-2663
(540) 371-9414
Mailing address
43 LITTLE WHIM RD, FREDERICKSBURG, VA 22405-1892
(703) 731-5462
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002086
VA
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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