Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 057002298 | IL |
NPI | 1194391011 |
---|---|
Provider Name | Valerie Pearl Lapsansky-Frizzo |
First Address | Mount Olive, IL 62069-2902 |
Second Address | Springfield, IL 62711-7380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2021 |
Last Update Date | 01/06/2021 |