Individual
MRS. HOLLY BIVONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13020 S CENTRAL AVE, CRESTWOOD, IL 60418-2710
(708) 389-0555
Mailing address
9384 CALUMET ST, DYER, IN 46311-2778
(708) 989-8617
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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