Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STACEY JO RUSSELL, PTA
ActiveSTACEY JO RUSSELL, PTA is a Occupational Therapist healthcare provider located in RIVERSIDE, Missouri. NPI 1033462114 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapist · RIVERSIDE, MO
Registration Details
- NPI Number
- 1033462114
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 26, 2012 (13.76354451525 yrs)
- Last Updated
- May 25, 2020
- Licenses
-
001388 (IA)2015030162 (MO)
Practice Information
- Address
-
4700 NW CLIFF VIEW DRRIVERSIDE, MO, 641501237Browse MO providers · Browse ZIP 64150
- Phone
- 8167415105
- Primary Specialty
-
Occupational Therapist
225200000X
- Additional Specialty
- Occupational Therapist
Other Occupational Therapist Providers in RIVERSIDE, MO
| Name | Credential | NPI |
|---|---|---|
| ELIZABETH DANIELLE HAM | — | 1548883549 |
| SHELBY JENNINGS SAILOR | PTA | 1487329231 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.