Individual
KRISTINA NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2650 N MONROE ST, DECATUR, IL 62526-3251
(217) 875-1973
Mailing address
361 S TAYLOR AVE, DECATUR, IL 62522-2758
(217) 685-0886
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.011795
IL
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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