Individual
ASHLEY KAY WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
601 LUTZ RD, BLOOMINGTON, IL 61704-8608
(309) 557-8000
Mailing address
601 LUTZ RD, BLOOMINGTON, IL 61704-8608
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005031
IL
Other
Enumeration date
10/28/2018
Last updated
10/28/2018
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