Stacey Lynn Davis, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Litchfield, IL

NPI 1851920334 · NPPES record last updated Apr 6, 2020

Key facts

NPI
1851920334
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057.003532 (IL)
Practice address
18 Pinewood Rd
Litchfield, IL 62056-1706
Phone
(217) 556-9126
NPI assigned
Apr 6, 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

LicenseStateTypeSpecialty
057.003532ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.003532 IL Yes

Addresses

Primary practice location

18 Pinewood Rd
Litchfield, IL 62056-1706

Mailing address

18 Pinewood Rd
Litchfield, IL 62056-1706

Other providers in Litchfield, IL

All providers in Litchfield, IL · Occupational Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.