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STEPHANIE WAGONER WALTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
875 PENNSYLVANIA AVE, SUITE A, BARDSTOWN, KY 40004-2529
(502) 349-6961
(502) 348-1789
Mailing address
1021 STONE HOUSE RIDGE RD, BARDSTOWN, KY 40004-9028
(502) 350-1151

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
KY-R2658
KY

Other

Enumeration date
10/31/2006
Last updated
08/22/2011
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