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Individual

HOLLY PROWANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
750 PASQUINELLI DR STE 204, WESTMONT, IL 60559-1291
(630) 560-0136
Mailing address
19 N STAFFIRE DR, SCHAUMBURG, IL 60194-3857
(630) 415-5044

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005391
IL

Other

Enumeration date
10/21/2020
Last updated
10/21/2020
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