Individual
GRISELDA EDITH HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2118 PEMBRIDGE LN, JOLIET, IL 60431-7728
(815) 768-7058
Mailing address
2118 PEMBRIDGE LN, JOLIET, IL 60431-7728
(815) 768-7058
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
08/20/2020
Last updated
07/26/2023
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