Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1023442894 |
---|---|
Provider Name | Stacy Sappenfield |
First Address | Highlands Ranch, CO 80163-1374 |
Second Address | Highlands Ranch, CO 80129-1709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2013 |
Last Update Date | 28/08/2013 |