Individual
MAURA KATHRYN IACOBUCCI
Active
Individual
MAURA KATHRYN IACOBUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
025011
NY
225X00000X
Occupational Therapist
056011801
IL
225X00000X
Occupational Therapist
46TR00945900
NJ
225XP0200X
Pediatric Occupational Therapist
Primary
056011801
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972691244
DO NOT TREAT MEDICAID OR MEDICARE PATIENTS
IL
Enumeration date
01/17/2017
Last updated
01/10/2023
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