Individual
MARY MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-0002
(217) 544-6464
(217) 757-6545
Mailing address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-0002
(217) 544-6464
(217) 757-6545
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.010479
IL
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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