Individual
JERANIQUE JERNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT-18-64604
Contact information
Practice address
5 REVERE DR STE 120, NORTHBROOK, IL 60062-8005
(847) 306-9843
Mailing address
5 REVERE DR STE 120, NORTHBROOK, IL 60062-8005
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
18-64604
MI
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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