Individual
MCKENZIE HULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056011253
IL
225X00000X
Occupational Therapist
Primary
349715
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500760019
—
OR
Enumeration date
10/22/2015
Last updated
04/02/2019
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