Individual
RAVEN VANTRYCE FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 PEACHTREE LN, FAIRVIEW HEIGHTS, IL 62208-3801
(618) 803-0372
Mailing address
5 PEACHTREE LN, FAIRVIEW HEIGHTS, IL 62208-3801
(618) 803-0372
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
224Z00000X
Occupational Therapy Assistant
Primary
—
TX
Other
Enumeration date
03/17/2025
Last updated
06/22/2026
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