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Individual

JAMIE LYNN NESNIDAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
452 N EOLA RD, SUITE A, AURORA, IL 60502-9612
(630) 999-0401
(630) 423-9669
Mailing address
2392 PUTNAM DR, NAPERVILLE, IL 60565-3044
(630) 853-9280

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-26554
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BACB358711
BACB
IL
Enumeration date
12/13/2016
Last updated
12/13/2016
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