Individual
KIRSTEN RENEE DIONELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
394 FEDERAL DR, CRYSTAL LAKE, IL 60014-6281
(630) 933-1500
Mailing address
394 FEDERAL DR, CRYSTAL LAKE, IL 60014-6281
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.015827
IL
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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