Individual
MARTHA DEHAKIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
804 STATE ST, #5, QUINCY, IL 62301-4951
(217) 224-1750
(217) 224-0403
Mailing address
804 STATE ST, #5, QUINCY, IL 62301-4951
(217) 224-1750
(217) 224-0403
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056005507
IL
Other
Enumeration date
10/26/2009
Last updated
10/26/2009
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