Individual
KRISTI MARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1000 E 6TH ST, PANA, IL 62557-1870
(217) 562-2174
Mailing address
9099 POSSUM TRL, FILLMORE, IL 62032-2105
(217) 638-3235
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002668
IL
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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