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1932784501
EMILY FAXON
SPRINGFIELD, IL
NPI
1932784501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057.005548)
Enumeration Date
2021-03-15
Last Update Date
2021-03-15
Business Address
EMILY FAXON COTA
2508 SAINT JAMES RD
SPRINGFIELD, IL 62707-9736
Phone number: 217-747-5901
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Mailing Address
EMILY FAXON COTA
2405 SHABBONA DR
SPRINGFIELD, IL 62702-1360
Phone number: 217-206-5713
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