Individual
MICHELLE DORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
(618) 937-1440
Mailing address
2000 CANDLESTICK LN, MARION, IL 62959
(618) 997-2035
(618) 937-1440
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.002348
IL
Other
Enumeration date
09/03/2015
Last updated
11/15/2016
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