Individual
MISS SWANNITA ANN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1618 S STANLEY ST, PEORIA, IL 61605-3142
(309) 922-1154
Mailing address
1618 S STANLEY ST, PEORIA, IL 61605-3142
(309) 922-1154
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057002865
IL
224Z00000X
Occupational Therapy Assistant
Primary
3966
CA
Other
Enumeration date
03/25/2011
Last updated
12/27/2018
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