IndividualActive
Terry Goheen, COTA/L
NPI 1093094013 · Occupational Therapy Assistant · Dow, IL
Provider details
- NPI number
- 1093094013
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA/L
- Sex
- Male
- Sole proprietor
- Yes
- License
- 057.003047 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
15874 Medora St
Dow, IL 62022-3173
Phone: (618) 885-5602
Approximate (ZIP-level) locationGet directions
Mailing address
15874 Medora St
Dow, IL 62022-3173
Registry dates
- Enumerated
- 2011-08-08
- Last updated
- 2011-08-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.