LUCHINNI PRABOWO-MANDAYO

PARK RIDGE, IL
NPI1801623152
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy106S00000X Behavior Technician
Enumeration Date2024-09-18
Last Update Date2024-09-18
Business Address
LUCHINNI PRABOWO-MANDAYO
444 N NORTHWEST HWY STE 147
PARK RIDGE, IL 60068-3263
Phone number: 847-610-9798
Mailing Address
LUCHINNI PRABOWO-MANDAYO
6246 N OAKLEY AVE APT 3
CHICAGO, IL 60659-2984
Phone number: 773-313-5529
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