Individual
BROOKE ELIZABETH MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
201 S 10TH ST, MASCOUTAH, IL 62258-1736
(618) 566-8000
Mailing address
3201 STATE ROUTE 150, CHESTER, IL 62233-2257
(618) 340-3601
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005907
IL
224Z00000X
Occupational Therapy Assistant
2022047867
MO
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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