Individual
ALYSSA MARIE GILLELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1373 DADRIAN PROFESSIONAL PARK, GODFREY, IL 62035-1767
(618) 208-2784
Mailing address
811 VALLEY DR, EAST ALTON, IL 62024-1623
(618) 623-1318
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003525
IL
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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