Tracy Marie Daniels COTA/L

NPI 1013164029 - Occupational Therapy Assistant - 224Z00000X

NPI Details
NPI 1013164029
Gender Female
Enumeration Date 08/20/2008
Last Updated 08/20/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1790 S FAIRVIEW AVE
DECATUR IL, 62521-4010, US
Phone (217) 429-2551
Fax (217) 422-6453
Business Location
101 E MOULTRIE ST
BEMENT IL, 61813-1542, US
Phone (217) 299-7493
Fax
Toxanomy
Taxonomy Code 224Z00000X
License State Illinois
License Number 057.002225
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According to our database, Miss Tracy Marie Daniels COTA/L NPI is 1013164029, taxonomy code is 224Z00000X and license number is 057.002225, license state is located at Illinois. Tracy Marie Daniels COTA/L physically located at 1790 S Fairview Ave, Decatur IL, 62521-4010. NPI Number Tracy Marie Daniels COTA/L has the Individual type.

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1013164029 NPI number is provided on an as is basis without warranty of any kind. 1013164029 is maintained by the National Plan & Provider Enumeration System. The contents of Tracy Marie Daniels COTA/L are for informational purposes only.