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Individual
SANDRA CHINNU MATHEW
Active
Individual
SANDRA CHINNU MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT-18-73304
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
18-73304
IL
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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