Individual
MRS. STACEY SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
300 BLAKE BLVD, PINEHURST, NC 28374-8474
(910) 295-6158
Mailing address
3920 YATESWOOD CT, RALEIGH, NC 27603-8824
(336) 466-2512
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7549
NC
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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