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Individual

LAVERNE REESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
150 S DURKIN DR APT, SPRINGFIELD, IL 62704-1151
(217) 381-7406
Mailing address
150 S DURKIN DR UNIT 7, SPRINGFIELD, IL 62704-1191
(217) 381-7406

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003241
IL

Other

Enumeration date
08/25/2020
Last updated
08/25/2020
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