Individual
MRS. JESIKA LYNN ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1111 W NORTH 12TH ST, SHELBYVILLE, IL 62565-9554
(217) 774-2111
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004949
IL
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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