Kathleen Marie Becket, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Dekalb, IL

NPI 1053960369 · NPPES record last updated Sep 9, 2019

Key facts

NPI
1053960369
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057.002479 (IL)
Practice address
428 W Lincoln Hwy RM 1
Dekalb, IL 60115-3003
Phone
(309) 883-1798
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
057.002479ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.002479 IL Yes

Addresses

Primary practice location

428 W Lincoln Hwy RM 1
Dekalb, IL 60115-3003

Mailing address

428 W Lincoln Hwy RM 1
Dekalb, IL 60115-3003
Phone (309) 883-1798

Other providers in Dekalb, IL

All providers in Dekalb, IL · Occupational Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.