Individual
ALEXANDER AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT-18-52915
Contact information
Practice address
528 HICKORY DR, ITASCA, IL 60143-1653
(630) 414-9504
Mailing address
528 HICKORY DR, ITASCA, IL 60143-1653
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
18-52915
IL
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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