Individual
MRS. BETHANY OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
RR 1 BOX 119A, KAMPSVILLE, IL 62053-9719
(618) 653-4304
Mailing address
RR 1 BOX 119A, KAMPSVILLE, IL 62053-9719
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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