Individual
SHANA B BERTELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10354 PRAIRIE DELL RD, SHIPMAN, IL 62685-6105
(618) 836-7442
(618) 836-5487
Mailing address
10354 PRAIRIE DELL RD, SHIPMAN, IL 62685-6105
(618) 836-7442
(618) 836-5487
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002709
IL
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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