Individual
JOSE MANUEL LEON BAHENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1845 GRANDSTAND PL, ELGIN, IL 60123-6603
(847) 695-0484
(847) 695-5496
Mailing address
1845 GRANDSTAND PL, ELGIN, IL 60123-6603
(847) 695-0484
(847) 695-5496
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/28/2023
Last updated
08/16/2023
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