Individual
ALICIA DEVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3516 W POWELL LN, MATTOON, IL 61938-2266
(217) 234-6402
Mailing address
3516 W POWELL LN, MATTOON, IL 61938-2266
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-006656
IL
225X00000X
Occupational Therapist
583-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056-006656
—
IL
Enumeration date
12/09/2013
Last updated
12/09/2013
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