Individual
MS. XIA DAE CUSHINGBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
332 S MICHIGAN AVE, CHICAGO, IL 60604-4393
(855) 832-6727
(772) 675-9100
Mailing address
10645 S HALE AVE APT 1, CHICAGO, IL 60643-2758
(312) 532-9251
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73459
IL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/08/2021
Last updated
07/02/2024
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