Individual
AMANDA NATALIE BAGBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
11560 S KEDZIE AVE, MERRIONETTE PARK, IL 60803-4517
(708) 792-0162
Mailing address
11560 S KEDZIE AVE, MERRIONETTE PARK, IL 60803-4517
(708) 792-0162
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12366459
IL
Other
Enumeration date
10/25/2021
Last updated
06/25/2025
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