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Individual

JACLYN A LAUDERBACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
26W171 ROOSEVELT RD, WHEATON, IL 60187-6002
(630) 909-7150
Mailing address
26W171 ROOSEVELT RD, WHEATON, IL 60187-6002

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.007897
IL

Other

Enumeration date
04/29/2021
Last updated
04/29/2021
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