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1285096768
STACY BLIDER
MOMENCE, IL
NPI
1285096768
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057002262)
Enumeration Date
2016-03-24
Last Update Date
2016-03-24
Business Address
Mrs. STACY BLIDER COTA
932 LOUISE DR
MOMENCE, IL 60954
Phone number: 708-400-1173
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Mailing Address
Mrs. STACY BLIDER COTA
932 LOUISE DR
MOMENCE, IL 60954-2326
Phone number: 708-400-1173
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