Individual
MARIA DANIELLE DYZENHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
9400 ORIOLE AVE, MORTON GROVE, IL 60053-1008
(847) 745-6479
Mailing address
3845 N ASHLAND AVE APT 2A, CHICAGO, IL 60613-2787
(224) 659-2386
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008975
IL
Other
Enumeration date
11/12/2017
Last updated
11/12/2017
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