Individual
IVETTE SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
550 W WEBSTER AVE, CHICAGO, IL 60614-3965
(773) 883-3860
Mailing address
815 N WASHTENAW AVE, CHICAGO, IL 60622-4430
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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