Individual
KELLY SHOWALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 REMINGTON RD STE K, SCHAUMBURG, IL 60173-4800
(847) 496-5513
Mailing address
8201 CASS AVE, DARIEN, IL 60561-5314
(630) 590-5571
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-52839
—
106S00000X
Behavior Technician
RBT-18-60816
IL
Other
Enumeration date
12/02/2020
Last updated
06/17/2024
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