Individual
KELLY MARIE NEWCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10400 S ROBERTS RD, PALOS HILLS, IL 60465-1972
(708) 443-7400
Mailing address
11130 S HOMAN AVE, CHICAGO, IL 60655-3504
(708) 925-7534
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
057004711
IL
Other
Enumeration date
10/21/2018
Last updated
10/21/2018
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