Individual
AVE GAY PANGANIBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 E ONTARIO ST, UNIT 801, CHICAGO, IL 60611-4804
(305) 934-6122
Mailing address
15874 NE 10TH CT, NORTH MIAMI BEACH, FL 33162-5350
(305) 934-6122
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011362
IL
225X00000X
Occupational Therapist
OT16470
FL
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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