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Individual

PAULETTE Y JAMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1705 W BLOOMINGTON RD APT 103L, CHAMPAIGN, IL 61821-0907
(872) 201-0101
Mailing address
1705 W BLOOMINGTON RD APT 103L, CHAMPAIGN, IL 61821-0907
(872) 201-0101

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
J52067985653
IL

Other

Enumeration date
12/12/2011
Last updated
12/12/2011
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