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Individual

MRS. KATHLEEN FINLEY LICAVOLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008866
IL
225X00000X
Occupational Therapist
2006026900
MO

Other

Enumeration date
03/08/2007
Last updated
05/07/2013
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