Individual
PAIGE PONTRELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
508 S LA GRANGE RD, LA GRANGE, IL 60525-6732
(708) 354-0942
(708) 354-0942
Mailing address
508 S LA GRANGE RD, LA GRANGE, IL 60525-6732
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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