Individual
TAYNA DENISE AYENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10836 S NORMAL AVE, CHICAGO, IL 60628-3226
(773) 230-3341
Mailing address
10836 S NORMAL AVE, CHICAGO, IL 60628-3226
(773) 230-3341
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
NA
IL
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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