Individual
TERA WENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
810 MARVIN ST, SOUTH BELOIT, IL 61080-2247
(815) 871-9222
Mailing address
810 MARVIN ST, SOUTH BELOIT, IL 61080-2247
(815) 871-9222
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7016
—
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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