Basic Information
| Provider Information | |||||||||
| NPI: | 1407289226 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILMAN | ||||||||
| FirstName: | STACEY | ||||||||
| MiddleName: | BARBER | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 177 SHILOH WOODS DR | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273719113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105718373 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 BLAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283748474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102956158 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2013 | ||||||||
| LastUpdateDate: | 08/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 8795 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.