Individual
STACY RAGNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4047 TUX RIVER CIR, DIBERVILLE, MS 39540-8888
(228) 424-6962
Mailing address
4047 TUX RIVER CIR, DIBERVILLE, MS 39540-8888
(228) 424-6962
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA1571
MS
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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