Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | A142-8139-1853 | IL |
NPI | 1003280553 |
---|---|
Provider Name | Teresa Marie Abels |
First Address | Joliet, IL 60436-1876 |
Second Address | Joliet, IL 60436-1876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2015 |
Last Update Date | 11/12/2015 |