Individual
ASHLEY TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
16521 W 159TH ST, LOCKPORT, IL 60441-7900
(815) 709-4603
Mailing address
14509 W MELBOURNE PL, LOCKPORT, IL 60441-6014
(708) 979-9599
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.015712
IL
Other
Enumeration date
10/16/2023
Last updated
02/02/2024
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