Individual
MRS. BETHANY RACHEAL JOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1605 SIDENER HALL, CHATHAM, IL 62629-2401
(217) 381-8487
Mailing address
309 S STATE ST, SPRINGFIELD, IL 62704-1756
(815) 721-3239
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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