Individual
MICHELLE VANSTADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1445 HOWELL AVE, BROOKSVILLE, FL 34601-1502
(352) 799-1451
Mailing address
105 AUTUMN CREST DR, MADISON, AL 35757-7554
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3652
FL
Other
Enumeration date
06/23/2019
Last updated
06/23/2019
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