Individual
FREDERICK BLACKMON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17627 BRIAR AVE, HOMEWOOD, IL 60430-1006
(708) 465-8060
Mailing address
17627 BRIAR AVE, HOMEWOOD, IL 60430-1006
(708) 465-8060
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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