Provider Demographics
NPI:1922383561
Name:NELSON, LINNEA ANNE (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:LINNEA
Middle Name:ANNE
Last Name:NELSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:815 N LARKIN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-3438
Mailing Address - Country:US
Mailing Address - Phone:815-730-1800
Mailing Address - Fax:815-730-1835
Practice Address - Street 1:815 N LARKIN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-3438
Practice Address - Country:US
Practice Address - Phone:815-730-1800
Practice Address - Fax:815-730-1835
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics