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General NPI Number Information
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NPI Number | 1134365240
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Entity Type | Individual
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Provider Name | STACY M WILCOX OT
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Gender | Female
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 20 AVON MEADOW LN STE 220
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City | AVON
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State | CT
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Zip | 06001-3731
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Country | US
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Telephone | 860-940-2413
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Fax | 860-854-2717
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Provider Business Mailing Address
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Address Line | 6 FERNWOOD DR
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City | SIMSBURY
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State | CT
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Zip | 06070-2902
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Country | US
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Telephone | 860-940-2413
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Fax | 860-854-2717
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 003498
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License Number State | CT
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