Individual
KARSEN ELAINE FUSSNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2220 STATE ST, PEKIN, IL 61554-3937
(309) 347-1110
Mailing address
4717 N KNOXVILLE AVE APT 324, PEORIA, IL 61614-6137
(309) 712-6211
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005628
IL
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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