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General NPI Number Information
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NPI Number | 1801311915
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Entity Type | Individual
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Provider Name | STACY BETH MONK
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Gender | Female
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Dates
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Enumeration Date | 08/09/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 860 WESLEY CIRCLE APT 104
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City | APOPKA
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State | FL
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Zip | 32703
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Country | US
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Telephone | 256-590-1480
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Fax |
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Provider Business Mailing Address
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Address Line | 860 WESLEY CIR APT 104
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City | APOPKA
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State | FL
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Zip | 32703-8646
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Country | US
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Telephone | 256-590-1480
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 16043
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License Number State | FL
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