Individual
BRIANA ELAN BENITEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4132 148TH ST, MIDLOTHIAN, IL 60445-3306
(708) 224-6381
Mailing address
4132 148TH ST, MIDLOTHIAN, IL 60445-3306
(708) 224-6381
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004056
IL
Other
Enumeration date
02/27/2016
Last updated
02/27/2016
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