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1164048567
ELLEIS MIRANDA
CHICAGO, IL
NPI
1164048567
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2020-06-22
Last Update Date
2022-05-09
Business Address
Ms. ELLEIS MIRANDA BS
304 N LOOMIS ST
CHICAGO, IL 60607-1147
Phone number: 312-243-8487
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Mailing Address
Ms. ELLEIS MIRANDA BS
304 N LOOMIS ST
CHICAGO, IL 60607-1147
Phone number: 312-243-8487
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