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Individual

MRS. KELLI RENEE MEENTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2805 BLAIR DR, CHAMPAIGN, IL 61821-3558
(217) 377-9329
Mailing address
2805 BLAIR DR, CHAMPAIGN, IL 61821-3558
(217) 377-9329

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.001808
IL

Other

Enumeration date
01/07/2013
Last updated
01/07/2013
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