Healthcare Provider Details

I. General information

NPI: 1275857039
Provider Name (Legal Business Name): STEFANIE FLORY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7862 EL CAJON BLVD
LA MESA CA
91942-6712
US

IV. Provider business mailing address

7862 EL CAJON BLVD
LA MESA CA
91942-6712
US

V. Phone/Fax

Practice location:
  • Phone: 619-466-7528
  • Fax:
Mailing address:
  • Phone: 619-466-7528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number6326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: