Individual
MS. VIVIAN JAMISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 RED BUD RD, BOLINGBROOK, IL 60490-6534
(630) 226-0268
Mailing address
1740 RED BUD RD, BOLINGBROOK, IL 60490-6534
(630) 226-0268
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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