Provider Demographics
NPI:1134367196
Name:JONES, MARIE L (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 ACORN DR
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:IL
Mailing Address - Zip Code:60118-2678
Mailing Address - Country:US
Mailing Address - Phone:847-428-4598
Mailing Address - Fax:
Practice Address - Street 1:929 ACORN DR
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:IL
Practice Address - Zip Code:60118-2678
Practice Address - Country:US
Practice Address - Phone:847-428-4598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056001033225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist