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General NPI Number Information
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NPI Number | 1184146433
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Entity Type | Individual
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Provider Name | TONYA GAIL TROXELL OTR/L, CLT
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Gender | Female
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 9515 HOLY CROSS LN
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City | BREESE
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State | IL
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Zip | 62230-3618
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Country | US
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Telephone | 618-526-5436
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Fax |
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Provider Business Mailing Address
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Address Line | 4637 KAY LYNN DR
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City | POCAHONTAS
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State | IL
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Zip | 62275-1748
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Country | US
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Telephone | 618-781-0114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2016019497
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.007316
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License Number State | IL
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