Individual
MARISSA VAVRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
1405 N HUNT CLUB RD, GURNEE, IL 60031-2656
(847) 855-2890
Mailing address
18W108 CLAREMONT DR, DARIEN, IL 60561-5702
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013736
IL
Other
Enumeration date
10/25/2020
Last updated
02/24/2022
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