Individual
MRS. JODI LYNN VERMILLION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A, BCBA
Contact information
Practice address
706 OGLESBY AVE STE 200, NORMAL, IL 61761-6430
(309) 585-2857
Mailing address
706 OGLESBY AVE STE 200, NORMAL, IL 61761-6430
(309) 481-5177
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-14-5920
IL
103K00000X
Behavior Analyst
Primary
1- 17- 25430
IL
Other
Enumeration date
04/08/2014
Last updated
04/04/2017
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