Individual
MARIAH HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2298
(779) 696-4595
(779) 696-3985
Mailing address
1401 E STATE ST, ROCKFORD, IL 61104-2298
(779) 696-4595
(779) 696-3985
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013065
IL
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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