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Individual

KATLYN MCGINNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
520 N MARSHFIELD AVE, CHICAGO, IL 60622-6731
(312) 243-6097
(312) 243-2076
Mailing address
6416 S LOCKWOOD AVE, CHICAGO, IL 60638-5717

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-21386
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000000
IL
Enumeration date
04/06/2016
Last updated
04/06/2016
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