Individual
ELNORA S JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 REVERE DR STE 120, NORTHBROOK, IL 60062
(844) 247-7222
Mailing address
2927 WILCOX AVE, BELLWOOD, IL 60104-2247
(615) 478-9287
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
18-56015
IL
2355S0801X
Speech-Language Assistant
3704019
AZ
Other
Enumeration date
05/13/2008
Last updated
09/05/2018
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