Individual
BRENDA ADOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 W. PARK ST., URBANA, IL 61801-2500
(217) 383-3800
(217) 383-3567
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6941
(217) 383-3567
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011040
IL
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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