Individual
JENNIFER NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R./L
Contact information
Practice address
1641 W. GENEVA RD, PEORIA, IL 61615
(309) 231-0461
(309) 691-9457
Mailing address
1641 W. GENEVA RD, PEORIA, IL 61615
(309) 231-0461
(309) 691-9457
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-004623
IL
225X00000X
Occupational Therapist
056004623
IL
Other
Enumeration date
10/03/2006
Last updated
07/21/2009
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