Individual
MRS. TIANA SHEVON KUBIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1346 W ESTES 1-S, CHICAGO, IL 60626-5475
(847) 881-6775
(248) 671-0487
Mailing address
1346 W ESTES 1-S, CHICAGO, IL 60626-5475
(847) 881-6775
(248) 671-0487
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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