Individual
AMANDA MARIA NUNEVILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
1422 W WILLOW ST, CHICAGO, IL 60642-8978
(773) 980-0300
Mailing address
545 N MCCLURG CT UNIT 3604, CHICAGO, IL 60611-3984
(856) 745-9248
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.012817
IL
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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