Individual
MARISSA WENOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
59 ORCHID DR, COLLINSVILLE, IL 62234-5809
(618) 791-7275
Mailing address
1211 SEASONS DR, GODFREY, IL 62035-5729
(618) 791-7275
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.014389
IL
225X00000X
Occupational Therapist
2021032399
MO
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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