Individual
JESSICA STAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
22317 DUPONT BLVD, GEORGETOWN, DE 19947-2153
(302) 253-1100
Mailing address
422 ROMANCOKE RD, STEVENSVILLE, MD 21666-2640
(410) 253-4026
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
09266
MD
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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