Abigail A Waters COTA/L

NPI 1790923530 - Occupational Therapy Assistant - 224Z00000X

NPI Details
NPI 1790923530
Gender Female
Enumeration Date 02/02/2009
Last Updated 02/02/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
311 W DEPOT ST
SUITE N
ANTIOCH IL, 60002-1500, US
Phone (847) 838-8085
Fax
Business Location
5803 32ND AVE
KENOSHA WI, 53144-4108, US
Phone (262) 945-4506
Fax
Toxanomy
Taxonomy Code 224Z00000X
License State Illinois
License Number 057003027
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According to our database, Mrs. Abigail A Waters COTA/L NPI is 1790923530, taxonomy code is 224Z00000X and license number is 057003027, license state is located at Illinois. Abigail A Waters COTA/L physically located at 311 W Depot St, Antioch IL, 60002-1500. NPI Number Abigail A Waters COTA/L has the Individual type.

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1790923530 NPI number is provided on an as is basis without warranty of any kind. 1790923530 is maintained by the National Plan & Provider Enumeration System. The contents of Abigail A Waters COTA/L are for informational purposes only.