Individual
JAYSIE PRUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1121 MICHAEL ST, LOCKPORT, IL 60441-3321
(855) 832-6727
Mailing address
1121 MICHAEL ST, LOCKPORT, IL 60441-3321
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
08/08/2026
Last updated
08/08/2026
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