Individual
MS. ANNA MARIE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2027 W 22ND PL, CHICAGO, IL 60608-4113
(773) 209-5721
Mailing address
2027 W 22ND PL, CHICAGO, IL 60608-4113
(773) 209-5721
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.002232
IL
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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