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1336853530
EBONIE DAUGHERTY
CHAMPAIGN, IL
NPI
1336853530
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-01-11
Last Update Date
2023-01-11
Business Address
EBONIE DAUGHERTY
517 W TOWN CENTER BLVD
CHAMPAIGN, IL 61822-1248
Phone number: 630-359-3629
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Mailing Address
EBONIE DAUGHERTY
517 W TOWN CENTER BLVD
CHAMPAIGN, IL 61822-1248
Phone number: 630-359-3629
Copy
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