Individual
MARIA MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3106 CARRIE ST, PERU, IL 61354-1494
(815) 993-3520
(815) 220-1670
Mailing address
3106 CARRIE ST, PERU, IL 61354-1494
(815) 993-3520
(815) 220-1670
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007738
IL
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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