Individual
ALICIA RANEE DAVIDSON-CREEKMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3109 E BRISTOL ST, ELKHART, IN 46514-4372
(574) 584-3324
Mailing address
110 EMS T17A LN, LEESBURG, IN 46538-9573
(574) 551-2199
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001873A
IN
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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