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Individual

STACEY MICHELLE DE YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
207 HUDDERSFIELD DR, SIMPSONVILLE, SC 29681-3703
(864) 987-0365
(678) 840-2112
Mailing address
PO BOX 369, SIMPSONVILLE, SC 29681-0369
(864) 201-4301
(678) 840-2112

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3068
SC

Other

Enumeration date
07/08/2006
Last updated
07/08/2007
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