| NPI | 1700192234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BUSH Credenitaling Manager 847-584-2604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2010-08-21 |
| Last Update Date | 2022-09-14 |