Individual
NICOLE MARIE HENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2400 GLENWOOD AVE, JOLIET, IL 60435-5474
(815) 741-7114
Mailing address
24451 SHAWANEE LN, MANHATTAN, IL 60442-1428
(815) 370-7686
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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