Individual
MRS. JENNIFER REBECCA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
623 HAMACHER ST, WATERLOO, IL 62298-1786
(618) 939-0400
(618) 939-0253
Mailing address
1317 SIMMONS RD, O FALLON, IL 62269-6607
(618) 401-9631
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056006313
IL
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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