Individual
SARA M BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, BCBA
Contact information
Practice address
650 W GRAND AVE STE 207, ELMHURST, IL 60126-1025
(630) 359-3629
Mailing address
650 W GRAND AVE STE 207, ELMHURST, IL 60126-1025
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36006
IL
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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