Individual
MOLLY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
310 CHURCH ST, ORAN, MO 63771-9602
(573) 262-3435
Mailing address
360 GALILEE RD, WOLF LAKE, IL 62998-1011
(618) 629-2060
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2021033962
MO
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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