Individual
BERTHA JASSO-NUNEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17124 INGLESIDE AVE, SOUTH HOLLAND, IL 60473-3506
(773) 621-9289
Mailing address
17124 INGLESIDE AVE, SOUTH HOLLAND, IL 60473-3506
(773) 621-9289
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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