Individual
MARISSA GATZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
1401 E 12TH ST, MENDOTA, IL 61342-9216
(815) 539-1620
(815) 538-5516
Mailing address
1401 E 12TH ST, MENDOTA, IL 61342-9216
(815) 539-1409
(815) 539-1652
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004493
IL
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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