| NPI | 1932790573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BUSH Credentialing Manager 847-584-2604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 104100000X Social Worker |
| 106S00000X Behavior Technician | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2022-09-14 |