Faith Basolo, COTA/L

NPI #1760835151 in Carterville, Illinois

Provider Information

NPI Number: 1760835151
Entity Type: Individual
Name: Faith Basolo, COTA/L
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: COTA/L
Enumeration Date: Jul 20, 2016
Last Updated: Dec 3, 2021

Practice Location

Address: 403 MUNICIPAL DR
City: Carterville
State: Illinois
ZIP Code: 62918-2042
Phone: (855) 608-3560

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapy Assistant	224Z00000X
Counselor	101Y00000X	Primary

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