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Individual

CARISSA GUALANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1911 ROHLWING RD STE A, ROLLING MEADOWS, IL 60008-1397
(224) 248-9449
Mailing address
1191 ROHLWING RD SUITE A, ROLLING MEADOWS, IL 60008
(224) 248-9449

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-19-79860
IL
225XP0200X
Pediatric Occupational Therapist
Primary
056.015084
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19-749860
RBT
IL
Enumeration date
09/05/2019
Last updated
05/04/2023
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