Individual
MRS. JILLYNNE JOYCE UTECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR, CHT
Contact information
Practice address
3545 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 269-5504
(417) 269-5508
Mailing address
31 SUMAC LN, MARSHFIELD, MO 65706-8184
(417) 859-7933
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2009008911
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009008911
STATE LICENSE
MO
Enumeration date
12/26/2006
Last updated
04/27/2020
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