Individual
CHRISTINA NOELLE GOUGHENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2100 S FINLEY RD, LOMBARD, IL 60148-4830
(630) 495-4000
Mailing address
1420 KENSINGTON RD STE 105, OAK BROOK, IL 60523-2144
(630) 286-8934
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.005763
IL
225XG0600X
Gerontology Occupational Therapist
056.005763
IL
Other
Enumeration date
07/17/2011
Last updated
07/17/2011
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