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Individual
RYAN J BONG
Active
Individual
RYAN J BONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT-19-107090
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-107090
IL
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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