Individual
STACY A HARMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT530
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150362
BLUE SHIELD
ID
01
—
W1044
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
02/09/2010
Update your record
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