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Individual

KATHRYN AYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
4214 W CARROUSEL LN, PEORIA, IL 61615-2843
(815) 499-8951
Mailing address
4214 W CARROUSEL LN, PEORIA, IL 61615-2843

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056012752
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
056012752
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
11/15/2018
Last updated
11/15/2018
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