Individual
SANDRA DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
156 HAVEN ST, COTTAGE HILLS, IL 62018-1243
(618) 259-2992
Mailing address
156 HAVEN ST, COTTAGE HILLS, IL 62018-1243
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.003215
IL
224Z00000X
Occupational Therapy Assistant
Primary
2010007408
MO
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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