Individual
MANDI BENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1197 S BUCHANAN ST, WILMINGTON, IL 60481-1616
(815) 603-4561
Mailing address
1197 S BUCHANAN ST, WILMINGTON, IL 60481-1616
(815) 603-4561
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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