MRS. Jennifer Sue Gottlob, COTA/L

NPI #1720304116 in Godfrey, Illinois

Provider Information

NPI Number: 1720304116
Entity Type: Individual
Name: MRS. Jennifer Sue Gottlob, COTA/L
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: COTA/L
Enumeration Date: Apr 11, 2010
Last Updated: Apr 11, 2010

Practice Location

Address: 1358 DADRIAN PROFESSIONAL PARK
City: Godfrey
State: Illinois
ZIP Code: 62035-1685
Phone: (618) 468-8010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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