Individual
MRS. AGNES LYNNE KOLETSOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT OTRL
Contact information
Practice address
516 N WOODFIELD TRAIL, ROSELLE, IL 60172
(847) 226-0193
Mailing address
516 N WOODFIELD TRAIL, ROSELLE, IL 60172
(847) 226-0193
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007678
IL
Other
Enumeration date
11/21/2006
Last updated
10/20/2008
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