Individual
STACEY RAE CROSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTL
Contact information
Practice address
1704 LAKEVIEW AVE, SAINT JOSEPH, MI 49085-1643
(812) 571-4658
Mailing address
1704 LAKEVIEW AVE, SAINT JOSEPH, MI 49085-1643
(812) 571-4658
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
315005094A
IN
225X00000X
Occupational Therapist
Primary
5201013903
MI
Other
Enumeration date
08/14/2020
Last updated
07/05/2024
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