Individual
ALYCIA DOMINION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 W RANDOLPH ST UNIT 608, CHICAGO, IL 60607-1432
(269) 470-1760
Mailing address
1400 W RANDOLPH ST UNIT 608, CHICAGO, IL 60607-1432
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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