Individual
MRS. LAVISHA NITA FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3209 GRAFTON LN, AURORA, IL 60502-7009
(630) 687-8963
Mailing address
3209 GRAFTON LN, AURORA, IL 60502-7009
(630) 687-8963
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-34066
IL
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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