Fenna, Carla Jo

Fenna, Carla Jo is an individual health care provider with primary practice located at 402 Jayde Place , Poplar Grove IL 61065-8314. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Fenna, Carla Jo can be contacted via phone (815) 765-2715.

Contact Information

Primary practice address
402 Jayde Place Poplar Grove IL 61065-8314
Phone: (815) 765-2715
Fax: (815) 765-2715
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X Illinois

Profile Details

NPI number 1609987395
LBN Legal business name Fenna, Carla Jo
Credentials OTRL
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609987395 NPPES
Illinois Other CF02520398P EARLY INTERVENTION

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