Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YS0200X | School Counselor | ||
Y | 103K00000X | Behavior Analyst | 1-14-15083 | IL |
NPI | 1053692608 |
---|---|
Provider Name | Jamie Rae Hitchins |
First Address | Joliet, IL 60435-6492 |
Second Address | Joliet, IL 60435-6492 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2011 |
Last Update Date | 15/08/2014 |