Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-16975 | IL |
NPI | 1013308154 |
---|---|
Provider Name | Dana Mascio |
First Address | Elmhurst, IL 60126-1025 |
Second Address | Elmhurst, IL 60126-1025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2015 |
Last Update Date | 19/11/2019 |