Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 056.012895 | IL |
NPI | 1003378985 |
---|---|
Provider Name | Justine Cabrera |
First Address | Westchester, IL 60154-4402 |
Second Address | Chicago, IL 60613-2407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2019 |
Last Update Date | 10/01/2021 |