Individual
JENNA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
1100 E NORRIS DR, OTTAWA, IL 61350-1604
(815) 431-5230
Mailing address
1100 E NORRIS DR, OTTAWA, IL 61350-1604
(815) 431-5230
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
291476
IL
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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