Individual
MISS KATRINA MORTA DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2320 PEBBLESTONE WAY, BOLINGBROOK, IL 60490-5059
(815) 782-4619
Mailing address
2320 PEBBLESTONE WAY, BOLINGBROOK, IL 60490-5059
(815) 782-4619
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.007949
IL
Other
Enumeration date
06/02/2010
Last updated
12/03/2012
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