Individual
JAZMIN OCTAVIA SUMMERISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, MS.
Contact information
Practice address
777 JOYCE RD, JOLIET, IL 60436-1876
(708) 543-1339
Mailing address
777 JOYCE RD, JOLIET, IL 60436-1876
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
05/10/2021
Last updated
05/10/2021
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