Individual
MISS STEFANIE ILIA-VICTORIA WOMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6650 W 33RD AVE APT 10, WHEAT RIDGE, CO 80033-6386
(307) 258-3403
Mailing address
6650 W 33RD AVE APT 10, WHEAT RIDGE, CO 80033-6386
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0000940
CO
Other
Enumeration date
12/26/2017
Last updated
12/26/2017
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