Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 056.000565 | IL |
NPI | 1073068540 |
---|---|
Provider Name | Maureen Deneen |
First Address | Naperville, IL 60540-6500 |
Second Address | Naperville, IL 60540-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2016 |
Last Update Date | 24/08/2016 |