Individual
MRS. KATHLEEN ELLEN PORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
931 SHETLAND DR, FRANKFORT, IL 60423-9767
(815) 469-6732
Mailing address
931 SHETLAND DR, FRANKFORT, IL 60423-9767
(815) 469-6732
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
11/08/2007
Last updated
11/14/2007
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