Individual
MISS LAVETTA MARIE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
308 N ORCHARD DR, PARK FOREST, IL 60466-1141
(708) 747-4685
Mailing address
308 N ORCHARD DR, PARK FOREST, IL 60466-1141
(708) 747-4685
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003861
IL
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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