Individual
ANDREA CANELO SERRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 N CATHERINE AVE, LA GRANGE, IL 60525-5930
(708) 482-9453
Mailing address
4747 S HAMLIN AVE, CHICAGO, IL 60632-3609
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-185806
IL
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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