Individual
MRS. STEPHANIE ANN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5202 SAINT JOE RD, FORT WAYNE, IN 46835-3380
(260) 918-0143
Mailing address
815 NUTTMAN AVE, FORT WAYNE, IN 46807-1845
(260) 755-9491
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001190A
IN
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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