Individual
JEFFRE KATHERINE YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3406 W BERTEAU AVE APT 1, CHICAGO, IL 60618-2208
(843) 860-0151
Mailing address
3406 W BERTEAU AVE APT 1, CHICAGO, IL 60618-2208
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005100
IL
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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