Individual
KELLY DUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSI, BCBA
Contact information
Practice address
310 N LOOMIS ST, CHICAGO, IL 60607
(312) 733-0883
Mailing address
310 N LOOMIS ST, CHICAGO, IL 60607-1147
(772) 285-8012
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29422
IL
Other
Enumeration date
03/14/2017
Last updated
05/23/2018
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