CARLY NICOLE DECKER

CHICAGO, IL
NPI1750651659
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: IL  056.009784)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: IN  99049402A)
Enumeration Date2012-01-09
Last Update Date2014-03-28
Business Address
CARLY NICOLE DECKER OT
929 W FOSTER AVE
CHICAGO, IL 60640-1491
Phone number: 812-236-9501
Mailing Address
CARLY NICOLE DECKER OT
929 W FOSTER AVE
CHICAGO, IL 60640-1491
Phone number: 812-236-9501