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Individual

JENNIFER R HAUSCHILD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
1047 CENTURY DR, EDWARDSVILLE, IL 62025-3772
(618) 307-3434
(618) 307-3435
Mailing address
13537 BARRETT PARKWAY DR, SUITE 105, BALLWIN, MO 63021-5899
(314) 821-9126
(314) 821-9142

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056004839
IL
225X00000X
Occupational Therapist
2012034579
MO

Other

Enumeration date
10/12/2012
Last updated
05/30/2013
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