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Individual

MRS. MARIAH MCCORMACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
7222 W CERMAK RD STE 4104TH, NORTH RIVERSIDE, IL 60546-1422
(707) 442-0023
Mailing address
4531 S ELLIS AVE APT 2, CHICAGO, IL 60653-4998
(231) 631-1709

Taxonomy

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

Other

Enumeration date
03/26/2024
Last updated
03/26/2024
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