Individual
KRISTOPHER KIELBASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 S CENTRAL AVE, CICERO, IL 60804-3956
(708) 863-3803
Mailing address
10440 S LAWNDALE AVE, CHICAGO, IL 60655-3120
(773) 350-7797
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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