Individual
MICHELLE RENEE PONSELLE-MAYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
498 S ROUTE 12, SUITE C, FOX LAKE, IL 60020-1908
(847) 587-3301
(847) 587-3346
Mailing address
498 S ROUTE 12, SUITE C, FOX LAKE, IL 60020-1908
(847) 587-3301
(847) 587-3346
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008351
IL
Other
Enumeration date
06/03/2008
Last updated
06/16/2008
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