Individual
MS. EBONY S HARDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1 INGALLS DR, HARVEY, IL 60426-3558
(708) 915-5431
Mailing address
300 ESCANABA AVE, CALUMET CITY, IL 60409-2019
(773) 719-8499
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004028
IL
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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