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1396433405
STACEY A BRYHAM
PENNSAUKEN, NJ
NPI
1396433405
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: FL OTA15799)
Enumeration Date
2023-04-26
Last Update Date
2023-04-26
Business Address
Mrs. STACEY A BRYHAM
7490 WALNUT AVE
PENNSAUKEN, NJ 08109-3077
Phone number: 856-839-1447
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Mailing Address
Mrs. STACEY A BRYHAM
6101 N FALLS CIRCLE DR APT 109
LAUDERHILL, FL 33319-6841
Phone number: 856-839-1447
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