Individual
KEESHA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
243 INDIANA ST, PARK FOREST, IL 60466-1164
(708) 261-2044
Mailing address
243 INDIANA ST, PARK FOREST, IL 60466-1164
(708) 261-2044
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004657
IL
Other
Enumeration date
09/09/2022
Last updated
09/09/2022
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