Individual
MRS. TAYLOR BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5370 KK RD, WATERLOO, IL 62298-3418
(618) 340-6625
Mailing address
5370 KK RD, WATERLOO, IL 62298-3418
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004701
IL
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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