Individual
ELLENA I BOUDOUVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1318 WAUKEGAN RD, GLENVIEW, IL 60025-3022
(847) 486-4140
Mailing address
1318 WAUKEGAN RD, GLENVIEW, IL 60025-3022
(847) 486-4140
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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