Individual
MRS. JESSICA ANN BIANCOSMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., D.T.
Contact information
Practice address
4310 N KILDARE AVE, CHICAGO, IL 60641
(773) 205-8284
Mailing address
4310 N KILDARE AVE, CHICAGO, IL 60641
(773) 205-8284
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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