Individual
JEANETTE MOTTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1318 WAUKEGAN RD, GLENVIEW, IL 60025-3022
(847) 486-4140
Mailing address
1633 RIDGE AVE APT 13-1, EVANSTON, IL 60201-5966
(715) 294-0190
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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