MISS Lavonne Elise Brock, COTA/L

NPI #1740562602 in Hazel Crest, Illinois

Provider Information

NPI Number
1740562602
Entity Type
Individual
Name
MISS Lavonne Elise Brock, COTA/L
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Occupational Therapy Assistant
Credential
COTA/L
Enumeration Date
Sep 15, 2011
Last Updated
Sep 15, 2011

Practice Location

Address
3206 WOODWORTH PL
ZIP Code
60429-1542
Phone
(773) 387-0513

Specialties & Taxonomy Codes

Specialty
Occupational Therapy Assistant

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