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Individual

EMMIE STANIFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1925 S MAIN ST STE A, BLOOMINGTON, IL 61704-7313
(309) 827-0934
Mailing address
3151 N 1400 EAST RD, MANSFIELD, IL 61854-6924

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
IL

Other

Enumeration date
01/04/2023
Last updated
01/09/2026
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