Individual
MRS. ABIGAIL BRYANNE HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
320 DOBSON ST APT B, CARTERVILLE, IL 62918-1549
(618) 638-2775
Mailing address
320 DOBSON ST APT B, CARTERVILLE, IL 62918-1549
(618) 638-2775
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004350
IL
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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