Individual
MISS KWANZA TANITA SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHP/ BA
Contact information
Practice address
1630 PLUM ST, AURORA, IL 60506-3462
(630) 966-4475
Mailing address
1630 PLUM ST, AURORA, IL 60506-3462
(630) 966-4475
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/07/2019
Last updated
04/07/2019
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