Provider Demographics
NPI:1376302687
Name:STUMM, EMMA BRETON
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:BRETON
Last Name:STUMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3399 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1261
Mailing Address - Country:US
Mailing Address - Phone:724-888-2548
Mailing Address - Fax:
Practice Address - Street 1:3399 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1261
Practice Address - Country:US
Practice Address - Phone:724-888-2548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC019835225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist