Provider Demographics
NPI:1346769007
Name:MAY, STACY (OTR/L)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9025 THOMPSON DR
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:TX
Mailing Address - Zip Code:76226-6508
Mailing Address - Country:US
Mailing Address - Phone:682-888-4133
Mailing Address - Fax:
Practice Address - Street 1:7500 STONEBROOK PKWY STE 102
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5378
Practice Address - Country:US
Practice Address - Phone:214-494-4677
Practice Address - Fax:214-494-2028
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118215225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist