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Individual

KARINA BRISENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1500 N CLYBOURN AVE UNIT C105, CHICAGO, IL 60610-2295
(312) 242-1665
Mailing address
241 W 29TH ST, SOUTH CHICAGO HEIGHTS, IL 60411-4757

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005311
IL

Other

Enumeration date
11/26/2019
Last updated
11/26/2019
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