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Individual

MARCIA ANN HATTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
606 SAINT THOMAS LN, CAHOKIA, IL 62206-1808
(618) 641-7363
Mailing address
606 SAINT THOMAS LN, CAHOKIA, IL 62206-1808
(618) 641-7363

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.003626
IL
224Z00000X
Occupational Therapy Assistant
Primary
2012020590
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
086146578
IL
Enumeration date
08/07/2012
Last updated
08/07/2012
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