Individual
JASON VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 S 521 RIVER OAKS DR, WARRENVILLE, IL 60555
(562) 644-7079
Mailing address
2 S 521 RIVER OAKS DR, WARRENVILLE, IL 60555
(562) 644-7079
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056012102
IL
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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