Individual
DEANDRA MUGNOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1845 OAK ST STE 15, NORTHFIELD, IL 60093-3022
(847) 386-6560
Mailing address
1845 OAK ST STE 15, NORTHFIELD, IL 60093-3022
(847) 386-6560
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056012723
IL
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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