Individual
MRS. SHIRLEY JO STICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
333 MEADE AVE, PUEBLO, CO 81001-4231
(719) 583-9785
Mailing address
333 MEADE AVE, PUEBLO, CO 81001-4231
(719) 583-9785
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
01/20/2014
Last updated
01/20/2014
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