Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003356049 |
---|---|
Provider Name | Danielle Zeisig |
First Address | Schaumburg, IL 60173-4151 |
Second Address | Schaumburg, IL 60173-4151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2017 |
Last Update Date | 23/02/2017 |