Individual
JENNIFER BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
201 E JACKSON ST, SAYBROOK, IL 61770-9497
(217) 714-8886
Mailing address
201 E JACKSON ST, SAYBROOK, IL 61770-9497
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003147
IL
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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