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Individual

KAY FOOTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
112 NE MADISON AVE, PEORIA, IL 61602-1109
(309) 674-7874
Mailing address
216 TIMBER LN, EAST PEORIA, IL 61611-1920
(309) 645-4112

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008469
IL
225X00000X
Occupational Therapist
114309
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225X00000X
OCCUPATIONAL THERAPIST
IL
01
225X00000X
OCCUPATIONAL THERAPIST
TX
Enumeration date
08/07/2011
Last updated
08/24/2015
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