Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 056.008467 | IL |
NPI | 1003258229 |
---|---|
Provider Name | Mrs. Lauren Rae Webb |
First Address | Barnhill, IL 62809-1038 |
Second Address | Mount Carmel, IL 62863-2905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2013 |
Last Update Date | 29/07/2013 |