Individual
ASHLEY GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
156 ROSS ST, WHITE HALL, IL 62092-1313
(217) 473-9313
Mailing address
156 ROSS ST, WHITE HALL, IL 62092-1313
(217) 473-9313
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003198
IL
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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