DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MISS LAVONNE ELISE BROCK, COTA/L

Active Sole Proprietor

MISS LAVONNE ELISE BROCK, COTA/L is a Occupational Therapy Assistant healthcare provider located in HAZEL CREST, Illinois. NPI 1740562602 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapy Assistant · HAZEL CREST, IL

Registration Details

NPI Number
1740562602
Provider Type
Individual
Gender
Female
NPI Issued
Sep 15, 2011 (14.905313929168 yrs)
Last Updated
Sep 15, 2011
License
057000445 (IL)
Sole Proprietor
Yes

Practice Information

Address
3206 WOODWORTH PL
HAZEL CREST, IL, 604291542
Browse IL providers · Browse ZIP 60429
Phone
7733870513
Primary Specialty
Occupational Therapy Assistant
224Z00000X

Other Occupational Therapy Assistant Providers in HAZEL CREST, IL

Name Credential NPI
MRS. BETH ANN CLOUD C.O.T.A./L. 1891708756
CHANEL RAYBON 1386295863
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.