Individual
JACILYN C DYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 LAFAYETTE AVE E, MATTOON, IL 61938-4641
(217) 235-5449
Mailing address
PO BOX 154, REDMON, IL 61949-0154
(217) 552-8942
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004792
IL
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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