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Individual

STEPHANIE DENICE WALCZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1650 INDIANTOWN RD, HENRY, IL 61537-9227
(309) 364-3905
(309) 364-3567
Mailing address
1650 INDIANTOWN RD, HENRY, IL 61537-9227
(309) 364-3905
(309) 364-3567

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
IL

Other

Enumeration date
03/31/2008
Last updated
03/31/2008
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