Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1336769645 |
---|---|
Provider Name | Elaina Dixon |
First Address | Glenview, IL 60026-8043 |
Second Address | Glenview, IL 60026-8043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2020 |
Last Update Date | 16/04/2020 |