Individual
JACQUELINE CAROL CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056010438
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056010438
ILLINOIS DEPT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
01
—
31005631A
PROFESSIONAL LICENSING AGENCY OF INDIANA
IN
Enumeration date
03/16/2015
Last updated
03/16/2015
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