Individual
NICOLE STELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-2600
Mailing address
4150 N SUNDERLAND DR, DECATUR, IL 62526-1749
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.007391
IL
Other
Enumeration date
06/29/2012
Last updated
09/06/2019
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