Individual
KATRINA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
700 E WALNUT ST, BLOOMINGTON, IL 61701-3244
(309) 829-1268
Mailing address
1404 N MAPLE ST, NORMAL, IL 61761-1422
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
056.000210
IL
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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