Individual
JENNIFER MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1318 WAUKEGAN RD, GLENVIEW, IL 60025-3022
(877) 486-4140
Mailing address
264 E DICKENS AVE, NORTHLAKE, IL 60164-1730
(773) 619-0199
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
24-344418
IL
Other
Enumeration date
09/28/2024
Last updated
09/28/2024
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