Individual
REBECCA KUSIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1925 S ARCHER AVE, CHICAGO, IL 60616-1618
(312) 554-5578
Mailing address
1925 S ARCHER AVE, CHICAGO, IL 60616-1618
(312) 554-5578
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-56793
IL
106S00000X
Behavior Technician
RBT-18-68575
IL
Other
Enumeration date
10/24/2018
Last updated
12/22/2021
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