Individual
KENDY R POLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1050 N REED STATION RD, CARBONDALE, IL 62902-7376
(618) 519-9590
Mailing address
101 OLIVIA DR, MARION, IL 62959-1388
(618) 771-2141
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004923
IL
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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