Emily Caroline Macias, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Godfrey, IL
NPI 1467070102 · NPPES record last updated Jul 9, 2020
Key facts
- NPI
- 1467070102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 057.005398 (IL)
- Practice address
- 1373 Dadrian Professional Park
Godfrey, IL 62035-1767 - Phone
- (618) 467-7062
- NPI assigned
- Jul 9, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057.005398 | IL | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 057.005398 | IL | Yes |
Addresses
Primary practice location
1373 Dadrian Professional Park
Godfrey, IL 62035-1767
Mailing address
4622 Valleydale Rd
Godfrey, IL 62035-4715
Phone (618) 600-3391
Other providers in Godfrey, IL
- Ron Loflin
- Sydnee Nicole Lollis
- Dana Renee Longmeyer
- Iona Lucas
- Keith Lyston
- Ashley Marchello
- Emily Suzanne Martin
- Norman Petronio Martinez Sr.
- Bradley D Martinson
- James Mathus
All providers in Godfrey, IL · Occupational Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.