Individual
MRS. KATIE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1320 W 9TH ST, MOUNT CARMEL, IL 62863-2905
(618) 263-4337
Mailing address
11613 E 940 LN, MOUNT CARMEL, IL 62863-4721
(618) 262-3772
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003092
IL
Other
Enumeration date
01/20/2019
Last updated
01/20/2019
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