Individual
ALISSA HAASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N COLLEGE AVE, GENESEO, IL 61254-1091
(309) 944-6431
Mailing address
600 N COLLEGE AVE, GENESEO, IL 61254-1091
(309) 944-6431
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.006680
IL
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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