Individual
GENTRY ROSE DRENTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
17833 HARLEM AVE, TINLEY PARK, IL 60477
(708) 782-4077
Mailing address
104 W SUMNER AVE, PEOTONE, IL 60468-9545
(708) 710-3312
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003230
IL
Other
Enumeration date
05/12/2010
Last updated
08/21/2018
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