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Individual

MICHAELA SHELLBY STACKHOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
32 OSGOOD ST, ANDOVER, MA 01810-5411
(978) 475-3806
Mailing address
295 SALEM ST UNIT 7, WOBURN, MA 01801-2066
(201) 925-1281

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
13900
MA
225XP0200X
Pediatric Occupational Therapist
Primary
13400
MA

Other

Enumeration date
12/18/2019
Last updated
03/01/2023
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