Individual
MS. STACY LYNNE DOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
90971 HIGHWAY 101 UNIT 77, WARRENTON, OR 97146-9346
(503) 861-8282
Mailing address
90971 HIGHWAY 101 UNIT 77, WARRENTON, OR 97146-9346
(503) 861-8282
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
391169
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
391169
OREGON STATE OCCUPATIONAL THERAPY LICENSE BOARD
OR
01
—
AA391169
NATIONAL BOARD FOR CERTIFICATION OIN OCCUPATIONAL THERAPY,INC
—
Enumeration date
01/11/2014
Last updated
01/11/2014
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