Individual
BRITTANI NICHOLE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
223 E 141ST ST, DOLTON, IL 60419-1103
(708) 848-1241
Mailing address
223 E 141ST ST, DOLTON, IL 60419-1103
(708) 848-1241
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003221
IL
Other
Enumeration date
03/19/2010
Last updated
03/19/2010
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