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1972364214
LOGAN PHENGSOMPHONE
SCHAUMBURG, IL
NPI
1972364214
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-01-23
Last Update Date
2024-01-23
Business Address
LOGAN PHENGSOMPHONE RBT
1300 REMINGTON RD STE K
SCHAUMBURG, IL 60173-4800
Phone number: 847-496-5513
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Mailing Address
LOGAN PHENGSOMPHONE RBT
8201 CASS AVE
DARIEN, IL 60561-5314
Phone number: 630-590-5571
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