Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | IL |
NPI | 1104964170 |
---|---|
Provider Name | Wendy Schmitz-Johnson |
First Address | Springfield, IL 62704-6713 |
Second Address | Springfield, IL 62704-7400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |