Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 056.007265 | IL |
NPI | 1033254461 |
---|---|
Provider Name | Miss Kristina Marie Spychalski |
First Address | Palos Heights, IL 60463-1055 |
Second Address | Palos Heights, IL 60463-1055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 25/09/2008 |