Individual
JESSICA MARIE BERRY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1700 WHITE ST, MOUNT VERNON, IL 62864-4349
(618) 242-4075
Mailing address
1531 MAUREEN DR, MARION, IL 62959-4614
(618) 964-5704
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005908
IL
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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