Individual
JAZ MCKENZIE KATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2103 N VETERANS PKWY STE 332, BLOOMINGTON, IL 61704-0917
(309) 585-1809
Mailing address
2103 N VETERANS PKWY STE 332, BLOOMINGTON, IL 61704-0917
(309) 585-1809
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057005634
IL
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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