Individual
KACIE LYNNE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2940 W 87TH ST, CHICAGO, IL 60652-3832
(773) 434-8787
Mailing address
13200 S BRANDON AVE, CHICAGO, IL 60633-1453
(773) 366-2658
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005051
IL
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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