Organization
SHOOTING STAR FEEDING AND SWALLOWING THERAPY
Active
Organization
SHOOTING STAR FEEDING AND SWALLOWING THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY L PANETTA OTR (OWNER)
(313) 478-1698
Entity
Organization
Contact information
Practice address
213 N SHELDON RD, PLYMOUTH, MI 48170-1524
(313) 478-1698
Mailing address
6647 BROOKSIDE LN, PLYMOUTH, MI 48170-5809
(313) 478-1698
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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