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1033764485
JUANITA BLACKMON
CHICAGO, IL
NPI
1033764485
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2019-08-02
Last Update Date
2019-08-02
Business Address
JUANITA BLACKMON MS
5904 S KEDZIE AVE APT 303
CHICAGO, IL 60629-3216
Phone number: 312-342-9118
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Mailing Address
JUANITA BLACKMON MS
5904 S KEDZIE AVE APT 303
CHICAGO, IL 60629-3216
Phone number: 312-342-9118
Copy
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