Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 11156 | NC |
NPI | 1003339045 |
---|---|
Provider Name | Stacy Wojy |
First Address | Brodheadsville, PA 18322-7129 |
Second Address | Port Orange, FL 32128-8321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2017 |
Last Update Date | 21/07/2017 |