Individual
LEAH KIRSTINE FREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 ERIN LN, KANKAKEE, IL 60901-5911
(815) 278-3147
Mailing address
12 ERIN LN, KANKAKEE, IL 60901
(815) 278-3147
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056010512
IL
Other
Enumeration date
03/22/2021
Last updated
03/22/2021
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