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Individual

SUSAN LYNN ZYLSTRA-HANSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4112B FIELDSTONE RD, CHAMPAIGN, IL 61822-8810
(888) 308-3728
Mailing address
PO BOX 7016, CHAMPAIGN, IL 61826-7016
(603) 369-9042

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056012908
IL

Other

Enumeration date
04/29/2019
Last updated
04/29/2019
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