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Individual

STEPHANIE MICHELLE WHISENAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1050 FOUNTAIN LAKES DR, O FALLON, IL 62269-2595
(779) 713-0903
Mailing address
1502 ASPEN CT, EDWARDSVILLE, IL 62025-5575
(309) 303-0894

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.002240
IL

Other

Enumeration date
03/31/2025
Last updated
03/31/2025
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