Stacey Michelle Foley

Individual provider Active NPI Occupational Therapy Assistant · Rock Spring, GA

NPI 1124360185 · NPPES record last updated Mar 17, 2013

Key facts

NPI
1124360185
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
001273 (GA)
Practice address
100 Autumn Crest TRL
Rock Spring, GA 30739-2095
Phone
(706) 375-1117
NPI assigned
Mar 17, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1930TNMDBehavioral Analyst
001273GAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1930 TN
Occupational Therapy Assistant 224Z00000X 001273 GA Yes

Addresses

Primary practice location

100 Autumn Crest TRL
Rock Spring, GA 30739-2095

Mailing address

100 Autumn Crest TRL
Rock Spring, GA 30739-2095
Phone (706) 375-1117

Other providers in Rock Spring, GA

All providers in Rock Spring, GA · Occupational Therapy Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.