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1013164029
TRACY MARIE DANIELS
DECATUR, IL
NPI
1013164029
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057.002225)
Enumeration Date
2008-08-20
Last Update Date
2008-08-20
Business Address
Miss TRACY MARIE DANIELS Cota/L
1790 S FAIRVIEW AVE
DECATUR, IL 62521-4010
Phone number: 217-429-2551
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Mailing Address
Miss TRACY MARIE DANIELS Cota/L
101 E MOULTRIE ST
BEMENT, IL 61813-1542
Phone number: 217-299-7493
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