| NPI | 1609295757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA MARIE KOOISTRA President 815-713-8792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1-10-6811) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |