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General NPI Number Information
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NPI Number | 1184295164
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Entity Type | Individual
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Provider Name | EMILY SLUSSER OT
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Gender | Female
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 1001 S STATE ST
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City | JERSEYVILLE
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State | IL
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Zip | 62052-2361
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Country | US
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Telephone | 618-498-6802
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Fax |
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Provider Business Mailing Address
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Address Line | 508 W PEARL ST
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City | JERSEYVILLE
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State | IL
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Zip | 62052-1523
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Country | US
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Telephone | 618-946-4063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056007159
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License Number State | IL
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