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1558952218
NICOLE DE VERA
ROCKFORD, IL
NPI
1558952218
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057.005510)
Enumeration Date
2021-01-26
Last Update Date
2021-01-26
Business Address
NICOLE DE VERA
4401 N MAIN ST
ROCKFORD, IL 61103-1277
Phone number: 815-921-9200
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Mailing Address
NICOLE DE VERA
4742 CARDAMON LN
ROCKFORD, IL 61114-5320
Phone number: 815-608-7501
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