Individual
REBECCA MARIE BOUDREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1823 S NEIL ST, CHAMPAIGN, IL 61820-7272
(224) 298-7462
Mailing address
8609 W BRYN MAWR AVE STE 204, CHICAGO, IL 60631-3524
(773) 644-7787
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58068
FL
Other
Enumeration date
05/10/2019
Last updated
09/30/2024
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