Individual
STACY SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
120 NW 28TH ST, GAINESVILLE, FL 32607-2511
(352) 246-5384
(352) 376-0126
Mailing address
379 MAGUIRE VLG APT 6, GAINESVILLE, FL 32603-2079
(352) 846-5492
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT7559
FL
Other
Enumeration date
04/11/2007
Last updated
07/09/2007
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