Mrs Jacqueline D Stroud, OT/L | |
118 Roger Dr, Collinsville, IL 62234-5814 | |
(618) 791-3923 | |
Not Available |
Full Name | Mrs Jacqueline D Stroud |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 118 Roger Dr, Collinsville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134442601 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 056006684 (Illinois) | Primary |
Provider Name | Legacy Healthcare Services Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1689141376 PECOS PAC ID: 2163339722 Enrollment ID: O20200427002510 |
Mailing Address | Practice Location Address |
---|---|
Mrs Jacqueline D Stroud, OT/L 118 Roger Dr, Collinsville, IL 62234-5814 Ph: (618) 791-3923 | Mrs Jacqueline D Stroud, OT/L 118 Roger Dr, Collinsville, IL 62234-5814 Ph: (618) 791-3923 |
Marissa Wenos, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 59 Orchid Dr, Collinsville, IL 62234 Phone: 618-791-7275 | |
Maria Nicole Luebbers, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1207 Vandalia St, Collinsville, IL 62234 Phone: 618-215-5315 | |
Kristen Hamlin, OTR Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1140 Collinsville Crossing Blvd, Collinsville, IL 62234 Phone: 618-578-5900 |