Individual
MRS. JACQUELINE D STROUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
118 ROGER DR, COLLINSVILLE, IL 62234-5814
(618) 791-3923
Mailing address
118 ROGER DR, COLLINSVILLE, IL 62234-5814
(618) 791-3923
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056006684
IL
Other
Enumeration date
03/11/2010
Last updated
03/11/2010
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