Individual
MS. MANDY DAWN CUMMINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1415 COUNTRY CLUB RD, MOUNT VERNON, IN 47620-9301
(812) 838-6554
Mailing address
302 W MAIN ST, CARMI, IL 62821-1471
(618) 599-5277
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001656A
IN
Other
Enumeration date
03/05/2010
Last updated
03/05/2010
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