Individual
BRIGITTE COGLIANESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1045 W STEPHENSON ST, FREEPORT, IL 61032-4864
(608) 324-2000
Mailing address
1045 WEST STEPHENSON ST, FREEPORT, IL 61032
(815) 599-6748
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.002967
IL
224Z00000X
Occupational Therapy Assistant
Primary
4613-027
WI
Other
Enumeration date
11/11/2009
Last updated
08/12/2011
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