Individual
DIAMOND LEIGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
122 CHILLON DR, LYNWOOD, IL 60411-6714
(708) 677-2925
Mailing address
122 CHILLON DR, LYNWOOD, IL 60411-6714
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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