Individual
MISS MARISSA ANN DASTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
2210 FOUNTAIN SQUARE DR, LOMBARD, IL 60148-5609
(630) 953-8990
Mailing address
21W005 HAMPTON LN, LOMBARD, IL 60148-5177
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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