Individual
STACI ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 MCCLENDON CHURCH RD, WEST MONROE, LA 71292-8052
(318) 362-5815
Mailing address
595 HARRELL RD, WEST MONROE, LA 71291-9739
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z12491
LA
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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