Individual
MRS. LESLIE D POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
2410 HILLCREST ST, HARRISBURG, IL 62946-3869
(618) 252-5258
Mailing address
2410 HILLCREST ST, HARRISBURG, IL 62946-3869
(618) 252-5258
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-006921
IL
Other
Enumeration date
04/11/2007
Last updated
04/06/2010
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