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Individual

MISS GRACE ANNE GOPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
6951 W FOSTER AVE, CHICAGO, IL 60656-3758
(312) 623-7508
(630) 953-6973
Mailing address
6951 W FOSTER AVE, CHICAGO, IL 60656-3758
(312) 623-7508
(630) 953-6973

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056009974
IL

Other

Enumeration date
07/02/2013
Last updated
07/02/2013
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