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Individual

JESSICA MARIE MEYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
3130 CHATHAM RD STE A, SPRINGFIELD, IL 62704-5379
(217) 718-4266
Mailing address
420 E CANEDY ST APT 2W, SPRINGFIELD, IL 62703-2254
(217) 620-2166

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005367
IL

Other

Enumeration date
03/04/2020
Last updated
03/04/2020
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