Individual
BROOKLYN CAMILLE DIEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
390 E CONGRESS PKWY STE M, CRYSTAL LAKE, IL 60014-6207
(866) 429-7543
Mailing address
615 CHESTNUT CT, ALGONQUIN, IL 60102-2117
(872) 222-3735
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-376010
IA
Other
Enumeration date
01/17/2025
Last updated
03/17/2025
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