Individual
MRS. MICHELLE BETH HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
14811 CALETTA TER, OAK FOREST, IL 60452-1111
(773) 852-8165
Mailing address
14811 CALETTA TER, OAK FOREST, IL 60452-1111
(773) 852-8165
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004243
IL
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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