NPI 1508107285

Charlene Pavesich

Practitioner Occupational Therapy Assistant Kankakee, IL

Practice location

Address: 350 N Wall St, Kankakee, IL 60901-2901
Phone: (815) 935-7514

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence 057001441 (IL)

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Registry record

NPI: 1508107285
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Mar 2013
Record last updated: 6 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.