| NPI | 1720357130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACIE YOUNG Owner 217-621-4441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: IL 056005118) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |