Individual
JENNA WAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
21 ORCHARD LN, MIDDLEFIELD, CT 06455-1151
(860) 250-5849
(860) 349-2280
Mailing address
8200 WOODGLEN LN, #201, DOWNERS GROVE, IL 60516-4551
(602) 471-6802
(630) 395-9198
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7692
IL
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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