Individual
MISS MRIDULA DHAMIJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3839 N KEYSTONE AVE, CHICAGO, IL 60641-3124
(859) 582-4742
Mailing address
3839 N KEYSTONE AVE, CHICAGO, IL 60641-3124
(859) 582-4742
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011458
IL
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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