Individual
IVY MAINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1515 N HARLEM AVE, OAK PARK, IL 60302-1250
(630) 632-4350
Mailing address
1515 N HARLEM AVE, OAK PARK, IL 60302-1250
(630) 632-4350
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-76515
IL
Other
Enumeration date
09/17/2020
Last updated
11/11/2024
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