Individual
MRS. MARIA ELLEN MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4700 MEMORIAL DR, BELLEVILLE, IL 62226-5373
(618) 257-5758
Mailing address
4700 MEMORIAL DR, BELLEVILLE, IL 62226-5373
(618) 257-5758
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002261
IL
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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