Individual
ASHLEY DAJAY ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8200 185TH ST STE AB, TINLEY PARK, IL 60487-9232
(708) 580-0440
(708) 263-0067
Mailing address
18927 BARBARA CT, LANSING, IL 60438-3601
(773) 931-6119
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056013256
IL
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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