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Individual

MRS. PATRICE M VANMALDEGIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2330 W GALENA BLVD, AURORA, IL 60506-4246
(630) 896-4686
Mailing address
925 WILKINSON LN, NORTH AURORA, IL 60542-8974
(630) 308-1893

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057-001085
IL

Other

Enumeration date
02/23/2021
Last updated
02/23/2021
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