Individual
LISA DEGENNARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
11858 RIVER HILLS PKWY, ROCKTON, IL 61072-9432
(815) 543-8972
Mailing address
11858 RIVER HILLS PKWY, ROCKTON, IL 61072-9432
(815) 543-8972
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.002490
IL
Other
Enumeration date
05/22/2009
Last updated
05/22/2009
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