Individual
ALEXIS JOELLE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 W E ST, BELLEVILLE, IL 62220-1055
(618) 791-3073
Mailing address
124 GREENVIEW ST, WOOD RIVER, IL 62095-3218
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183390103
—
IL
Enumeration date
04/25/2019
Last updated
04/25/2019
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