Individual
MRS. MAREIKO MICHELLE AU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4677 N VIRGINIA AVE, 1N, CHICAGO, IL 60625-2953
(312) 520-4657
Mailing address
4677 N VIRGINIA AVE, 1N, CHICAGO, IL 60625-2953
(312) 520-4657
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/12/2012
Last updated
01/09/2013
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