Individual
TYRA HOULNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
901 MILL ST, YORKVILLE, IL 60560-1729
(630) 553-4388
Mailing address
602 CENTER PKWY STE A, YORKVILLE, IL 60560-1499
(630) 553-4382
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057001877
IL
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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