Individual
CHARELL NICOLE BRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6824 S CAMPBELL AVE, CHICAGO, IL 60629-1323
(312) 897-8643
Mailing address
6824 S CAMPBELL AVE, CHICAGO, IL 60629-1323
(312) 897-8643
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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