Individual
MRS. JESSICA JANELLE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
216 COLLEGE BLVD, CARMI, IL 62821-1548
(618) 382-2923
Mailing address
256 COUNTY ROAD 400 E, NORRIS CITY, IL 62869-3909
(618) 962-3070
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007162
IL
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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