Individual
MRS. ELIZABETH ROXANNE KELSO SIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3048 N MILWAUKEE AVE, CHICAGO, IL 60618-6624
(773) 595-6786
Mailing address
2339 N CALIFORNIA AVE UNIT 47949, CHICAGO, IL 60647-0360
(773) 595-6786
(773) 305-8082
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-30563
IL
Other
Enumeration date
07/30/2018
Last updated
04/01/2019
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