Fouke, Staci Lyn

Fouke, Staci Lyn is an individual health care provider with primary practice located at 250 Santa Fe Dr , Weatherford TX 76086-6585. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Fouke, Staci Lyn can be contacted via phone (817) 550-5058.

Contact Information

Primary practice address
250 Santa Fe Dr Weatherford TX 76086-6585
Phone: (817) 550-5058
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 114005 Texas

Profile Details

NPI number 1881963551
LBN Legal business name Fouke, Staci Lyn
Credentials MS, OTR
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2011
Last updated Mar 20th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881963551 NPPES
Texas MEDICAID 1764490-07

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