Individual
MICHELLE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5520 LINCOLN AVE, MORTON GROVE, IL 60053-3416
(224) 707-0885
Mailing address
8201 S INDIANA AVE, APT 3, CHICAGO, IL 60619-4754
(773) 398-3760
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004516
IL
Other
Enumeration date
05/25/2016
Last updated
05/25/2016
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