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Individual

STACY M CONWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., OTR/L

Contact information

Practice address
35 BLANCHE ST, DRACUT, MA 01826-3823
(617) 359-5855
Mailing address
35 BLANCHE ST, DRACUT, MA 01826-3823

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3045
SC
225X00000X
Occupational Therapist
Primary
7880
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
TH1625
SC
Enumeration date
07/26/2006
Last updated
06/30/2014
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