Individual
STACEY LEA RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1883 SHUMWAY HILL RD, WELLSBORO, PA 16901-6840
(570) 724-5270
(570) 724-5276
Mailing address
111 W MICHIGAN ST, 9TH FLOOR, MILWAUKEE, WI 53203-2903
(414) 908-8787
(414) 918-2573
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006995
PA
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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