Individual
MOLLY K. SUELLENTROP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4450 N PROSPECT RD STE C5, PEORIA HEIGHTS, IL 61616-6578
(309) 363-7594
(309) 966-3621
Mailing address
4450 N PROSPECT RD STE C5, PEORIA HEIGHTS, IL 61616-6578
(309) 363-7594
(309) 966-3621
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003889
IL
Other
Enumeration date
03/14/2025
Last updated
03/14/2025
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