Individual
VANESSA K BOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1028 W HILLCREST DR, CHILLICOTHE, IL 61523-2258
(309) 274-2194
Mailing address
22918 N MAHER RD, PRINCEVILLE, IL 61559-9429
(309) 360-2327
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057005267
IL
Other
Enumeration date
01/19/2020
Last updated
01/19/2020
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