Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0200X | Occupational Therapist - Pediatrics | IL |
NPI | 1063891984 |
---|---|
Provider Name | April Washington |
First Address | Park Forest, IL 60466 |
Second Address | Park Forest, IL 60466 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2015 |
Last Update Date | 26/05/2015 |