Individual
STACEY CHARMOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA BCBA
Contact information
Practice address
18550 W MILLBURN RD, OLD MILL CREEK, IL 60083-9248
(270) 777-9283
(270) 777-9283
Mailing address
PO BOX 51322, BOWLING GREEN, KY 42102-5622
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-15388
IL
Other
Enumeration date
04/09/2014
Last updated
06/26/2017
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