Individual
MS. CRYSTAL DANAE' POMBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
210 N PRAIRIE, GRANT PARK, IL 60940-7154
(815) 662-8209
Mailing address
PO BOX 194, GRANT PARK, IL 60940-0194
(815) 662-8209
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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