Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 056011122 | IL |
NPI | 1215409354 |
---|---|
Provider Name | Chelsea Rippelmeyer |
First Address | Belleville, IL 62226-5360 |
Second Address | Belleville, IL 62226-5360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2018 |
Last Update Date | 31/12/2018 |