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Individual

MRS. KRISTINE ELIZABETH HETTENHAUSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
509 HADDINGTON LN, O FALLON, IL 62269-4242
(618) 632-3234
Mailing address
509 HADDINGTON LN, O FALLON, IL 62269-4242
(618) 632-3234

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-005370
IL

Other

Enumeration date
02/10/2009
Last updated
02/10/2009
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