| NPI | 1003356817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA L GOLLADAY Owner 309-824-7417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IL 056006902) |
| Additional Taxonomies | 225XF0002X Occupational Therapist, Feeding, Eating & Swallowing (Licence: IL 056006902) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: IL 056006902) | |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |