Individual
AMANDA EILEEN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
3703 WEST LAKE AVENUE, GLENVIEW, IL 60026
(847) 998-1188
Mailing address
3703 W LAKE AVE, GLENVIEW, IL 60026-5823
(847) 998-1188
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008524
IL
Other
Enumeration date
04/29/2009
Last updated
04/29/2009
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