Individual
AMANDA RAE MINAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1921 W IRVING PARK RD, CHICAGO, IL 60613-2407
(312) 243-8487
Mailing address
1921 W IRVING PARK RD, CHICAGO, IL 60613-2407
(312) 243-8487
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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