Individual
ALLISON RAE BRUCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
938 169TH ST # 2, HAMMOND, IN 46324-2038
(773) 484-3119
Mailing address
938 169TH ST # 2, HAMMOND, IN 46324-2038
(773) 484-3119
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-66875
IL
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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