Individual
TAYLOR LYNNE SPIVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 PARK LN W, CLINTON, IL 61727-2637
(217) 935-8500
Mailing address
1804 COTTAGE AVE, BLOOMINGTON, IL 61701-1417
(217) 377-7933
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
NA
IL
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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