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1497976195
DIANE M STACKER
SOUTH BEND, IN
NPI
1497976195
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
Enumeration Date
2007-05-01
Last Update Date
2007-07-09
Business Address
Ms. DIANE M STACKER O.T.
2505 E JEFFERSON BLVD
SOUTH BEND, IN 46615-2635
Phone number: 574-289-4831
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Mailing Address
Ms. DIANE M STACKER O.T.
PO BOX 1049
SOUTH BEND, IN 46624-1049
Phone number: 574-289-4831
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