Individual
MS. NICHOLLE LEIGH EISFELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,OT/L,CHT
Contact information
Practice address
1111 TRINITY LANE, SUITE 111, BLOOMINGTON, IL 61704-3738
(309) 663-6461
(309) 663-5711
Mailing address
1111 TRINITY LANE, SUITE 111, BLOOMINGTON, IL 61704-3738
(309) 663-6461
(309) 663-5711
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056004933
IL
225XH1200X
Hand Occupational Therapist
Primary
056004933
IL
Other
Enumeration date
11/13/2008
Last updated
10/21/2016
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