Individual
MRS. JENNIFER SUE GOTTLOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1358 DADRIAN PROFESSIONAL PARK, GODFREY, IL 62035-1685
(618) 468-8010
Mailing address
1358 DADRIAN PROFESSIONAL PARK, GODFREY, IL 62035-1685
(618) 468-8010
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
057-001740
IL
Other
Enumeration date
04/11/2010
Last updated
04/11/2010
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