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Individual

IISHA SUMMERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
823 HERMANS LN, JOLIET, IL 60433-2607
(779) 379-0199
Mailing address
823 HERMANS LN, JOLIET, IL 60433-2607
(779) 379-0199

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
IL

Other

Enumeration date
04/15/2020
Last updated
04/15/2020
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