Individual
MRS. DAVONIA CAROLANN DIRR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
640 E SAINT CHARLES RD, 104, CAROL STREAM, IL 60188-3083
(630) 460-3431
Mailing address
77 VANTROBA DR, GLENDALE HEIGHTS, IL 60139-2710
(630) 290-0141
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.010208
IL
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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