Individual
MS. KRYSTAL LARAINA SIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
14226 S MICHIGAN AVE, RIVERDALE, IL 60827-2514
(708) 841-7995
Mailing address
14226 S MICHIGAN AVE, RIVERDALE, IL 60827-2514
(773) 298-1177
(773) 298-0689
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.001481
IL
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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