Individual
TAMMY WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
725 N SANGAMON AVE, GIBSON CITY, IL 60936-1152
(217) 417-2000
Mailing address
725 N SANGAMON AVE, GIBSON CITY, IL 60936-1152
(217) 417-2000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057001785
IL
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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