Individual
MISS CHEYENNE LAURA DILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1183 LUTHER DR, HAGERSTOWN, MD 21740-7407
(240) 420-4138
Mailing address
668 CUMBERLAND AVE APT B, CHAMBERSBURG, PA 17201-3869
(717) 830-8220
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP009375
PA
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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