Individual
JASMINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7936 S CONSTANCE AVE, CHICAGO, IL 60617-1025
(773) 744-0924
Mailing address
7936 S CONSTANCE AVE, CHICAGO, IL 60617-1025
(773) 744-0924
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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