Provider Demographics
NPI:1932376431
Name:PEOPLES, VERNETTA ROCHE (OTR/L)
Entity Type:Individual
Prefix:
First Name:VERNETTA
Middle Name:ROCHE
Last Name:PEOPLES
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 1:14215 COTTAGE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-1354
Mailing Address - Country:US
Mailing Address - Phone:708-655-6344
Mailing Address - Fax:708-841-3265
Practice Address - Street 1:42 163RD PL
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-6002
Practice Address - Country:US
Practice Address - Phone:708-655-6344
Practice Address - Fax:708-841-3265
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.005631225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist