Individual
MRS. COLLEEN ANN RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
390 E CONGRESS PKWY, CRYSTAL LAKE, IL 60014-6202
(815) 477-4788
Mailing address
5202 HEATHER LN, JOHNSBURG, IL 60051-5215
(815) 245-7986
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004031
IL
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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