Minetta Wallingford, OTR/L

NPI #1174160634 in Riverside, Illinois

Provider Information

NPI Number: 1174160634
Entity Type: Individual
Name: Minetta Wallingford, OTR/L
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: OTR/L
Enumeration Date: Dec 4, 2019
Last Updated: Dec 4, 2019

Practice Location

Address: 423 ADDISON RD
City: Riverside
State: Illinois
ZIP Code: 60546-2007
Phone: (773) 715-8463

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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