Individual
MRS. ABIGAIL A WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
311 W DEPOT ST, SUITE N, ANTIOCH, IL 60002-1500
(847) 838-8085
Mailing address
5803 32ND AVE, KENOSHA, WI 53144-4108
(262) 945-4506
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003027
IL
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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