Individual
GWEN HEIFNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 ROYCE RD STE 12, BOLINGBROOK, IL 60440-1409
(312) 882-1024
(312) 488-3663
Mailing address
101 ROYCE RD STE 12, BOLINGBROOK, IL 60440-1409
(312) 882-1024
(312) 488-3663
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-35201
IL
Other
Enumeration date
06/25/2019
Last updated
11/27/2023
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