Individual
MRS. MELISSA MARIE GENINATTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
237 W BURROUGHS ST, WORDEN, IL 62097-1255
(618) 980-0392
Mailing address
237 W BURROUGHS ST, WORDEN, IL 62097-1255
(618) 980-0392
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003395
IL
Other
Enumeration date
12/20/2020
Last updated
12/20/2020
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