| NPI | 1992103683 |
|---|---|
| Former Name | STEPHANIE MICHELE BLAKELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |