Individual
MS. ELLEN M MARQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3108 RURAL ST, ROCKFORD, IL 61107-3461
(815) 229-6315
Mailing address
3108 RURAL ST, ROCKFORD, IL 61107-3461
(815) 229-6315
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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