Individual
FARIDA K TAVAWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
470 FAWELL BLVD, APT 511, GLEN ELLYN, IL 60137-6796
(201) 743-9677
Mailing address
470 FAWELL BLVD, APT 511, GLEN ELLYN, IL 60137-6796
(201) 743-9677
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009971
IL
Other
Enumeration date
01/16/2013
Last updated
01/16/2013
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