Individual
KATELYN ANN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1111 TRINITY LN STE 111, BLOOMINGTON, IL 61704-8112
(309) 608-5100
Mailing address
1170 LYNX LN, NORMAL, IL 61761-9389
(309) 310-3931
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011136
IL
Other
Enumeration date
10/03/2024
Last updated
01/23/2025
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