Individual
PEGGY NEWBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3920 PINTAIL DR STE B, SPRINGFIELD, IL 62711-9415
(217) 891-1524
Mailing address
610 MAYO ST, CARLINVILLE, IL 62626-1900
(217) 825-6320
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057000931
IL
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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