Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | IL |
NPI | 1235115122 |
---|---|
Provider Name | Geraldine Uy Eichhorn |
First Address | Herrin, IL 62948-3631 |
Second Address | Herrin, IL 62948-3631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 08/07/2007 |