IndividualActive
Beverly Stephens, COTA/L
NPI 1104298645 · Gerontology Occupational Therapist · Peoria, IL
Provider details
- NPI number
- 1104298645
- Entity type
- Individual
- Primary specialty
- Gerontology Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- Yes
- License
- 057'002773 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
3020 N Victoria Ave
Peoria, IL 61604-2322
Phone: (309) 657-8704
Approximate (ZIP-level) locationGet directions
Mailing address
3020 N Victoria Ave
Peoria, IL 61604-2322
Registry dates
- Enumerated
- 2015-10-23
- Last updated
- 2015-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.