STACEY S VOLLENWEIDER

PICAYUNE, MS
NPI1417245648
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: MS  OT1249)
Additional Taxonomies225XP0200X Occupational Therapist Pediatrics
(Licence: MS  OT1249)
Enumeration Date2011-07-21
Last Update Date2014-12-31
Business Address
MRS. STACEY S VOLLENWEIDER OTR/L
311 N MAIN ST
PICAYUNE, MS 39466-3313
Phone number: 601-799-4065
Mailing Address
MRS. STACEY S VOLLENWEIDER OTR/L
7533 CROOKED STICK DR
DIAMONDHEAD, MS 39525-3895
Phone number: 228-216-9996