Individual
KATELYN NICOLE HERNDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT-17-27780
Contact information
Practice address
45 HUNTER DR, MONTGOMERY, IL 60538-2059
(630) 608-8077
Mailing address
45 HUNTER DR, MONTGOMERY, IL 60538-2059
(630) 608-8077
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-27780
IL
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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