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Individual

MAKALEY M VELAZQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
105 E 23RD ST, STERLING, IL 61081-1212
(425) 481-5626
Mailing address
28740 W THOME RD, ROCK FALLS, IL 61071-9263
(815) 718-0918

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005885
IL
224Z00000X
Occupational Therapy Assistant
098797
IA

Other

Enumeration date
04/10/2023
Last updated
04/10/2023
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