Individual
TRACIE STANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
27 QUAKER LN, SOUTHINGTON, CT 06489-3955
(860) 621-9751
Mailing address
27 QUAKER LN, SOUTHINGTON, CT 06489-3955
(860) 621-9751
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000487
CT
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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