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Individual

ALEJANDRA BOLANOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
306 N KENSINGTON AVE, LA GRANGE PARK, IL 60526-1870
Mailing address
306 N KENSINGTON AVE, LA GRANGE PARK, IL 60526-1870

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
02/28/2020
Last updated
02/28/2020
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