Individual
MS. KENYA NICOLE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6204 POND VIEW DR, MATTESON, IL 60443-2479
(773) 617-0478
Mailing address
6204 POND VIEW DR, MATTESON, IL 60443-2479
(773) 617-0478
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.005572
IL
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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