Individual provider · Type 1 NPI

Jefferson James Mahinay Licup, OTR/L

Occupational Therapist · Bolingbrook, IL

NPI number 1437484110 Active

Practice location

226 Tiger St
Bolingbrook, IL 60490-2053

Call (708) 822-8886 Map

Fax (630) 378-4839

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000X056007185 (IL)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1437484110

Jefferson James Mahinay Licup, OTR/L's National Provider Identifier is 1437484110, issued on Oct 13, 2009. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Bolingbrook, IL. The record was last updated on Oct 13, 2009.