Individual
KELLY DEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.T
Contact information
Practice address
670 W HUBBARD ST, CHICAGO, IL 60654-5537
(312) 733-0883
Mailing address
670 W HUBBARD ST, CHICAGO, IL 60654-5537
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/23/2012
Last updated
01/23/2012
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