Individual
MAGEN GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4910 ALGIRE RD, BELLVILLE, OH 44813-9263
(419) 886-3922
Mailing address
1929 S LEXINGTON SPRINGMILL RD, MANSFIELD, OH 44904-8613
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA007346
OH
Other
Enumeration date
05/21/2021
Last updated
05/21/2021
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