Individual
MS. KILEY WALLDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4617 WHITE OAK AVE, ROCKFORD, IL 61114-6235
(815) 601-7581
Mailing address
4617 WHITE OAK AVE, ROCKFORD, IL 61114-6235
(815) 601-7581
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
56.011160
IL
Other
Enumeration date
04/27/2017
Last updated
11/06/2019
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