Individual
MRS. NIKKI DIANE LYNCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
RR3 BOX 108, MCLEANSBORO, IL 62859
(618) 757-2267
Mailing address
RR 3 BOX 108, MC LEANSBORO, IL 62859-9538
(618) 757-2267
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003116
IL
Other
Enumeration date
07/17/2009
Last updated
07/17/2009
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