Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 056.011844 | IL |
NPI | 1003356551 |
---|---|
Provider Name | Miss Nadia Marasti |
First Address | Deerfield, IL 60015-2143 |
Second Address | Deerfield, IL 60015-2143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2017 |
Last Update Date | 03/03/2017 |