Individual
TANYA JEFFERSON-FITTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1228 S KOLIN AVE, CHICAGO, IL 60623-1138
(773) 972-6599
Mailing address
1228 S KOLIN AVE, CHICAGO, IL 60623-1138
(773) 972-6599
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
J16281270816
IL
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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