Individual
MOLLY DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, MSOT, OTR/L
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-2530
(217) 258-4176
Mailing address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-2530
(217) 258-4176
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056013017
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056013017
LICENSE
IL
Enumeration date
11/21/2019
Last updated
11/21/2019
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