Individual
MARIAH STUBBLEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
14840 STATE HIGHWAY 14, BENTON, IL 62812-4712
(618) 218-5006
Mailing address
14840 STATE HIGHWAY 14, BENTON, IL 62812-4712
(618) 218-5006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009881
IL
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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