Individual
SAMANTHA PIASNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1009 IL ROUTE 22 STE 1, FOX RIVER GROVE, IL 60021-1998
(847) 462-8707
Mailing address
1009 IL ROUTE 22 STE 1, FOX RIVER GROVE, IL 60021-1998
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057005177
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HMM00004
—
IL
Enumeration date
07/17/2019
Last updated
07/17/2019
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