Individual
KASARA N BACHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
201 S SPRUCE ST, MALDEN, IL 61337-9466
(815) 876-6008
Mailing address
201 S SPRUCE ST, MALDEN, IL 61337-9466
(815) 876-6008
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005005
IL
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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