Individual
MRS. JODI LYNN NIBBELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA L, ATP
Contact information
Practice address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 842-2828
Mailing address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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