Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 056010721 | IL |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 056010721 | IL |
NPI | 1467839142 |
---|---|
Provider Name | Maridy Tojos-Cruz |
First Address | Orland Park, IL 60467-5602 |
Second Address | Orland Park, IL 60467-5602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2015 |
Last Update Date | 01/05/2015 |