Individual
KATILYN RENEE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1601 BUTTERFIELD TRL, KANKAKEE, IL 60901-2959
(815) 936-6500
Mailing address
10133 SHERRILL BLVD STE 200, KNOXVILLE, TN 37932-3347
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004917
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174603377
—
IL
Enumeration date
06/30/2022
Last updated
06/30/2022
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