Individual
FIDA KHATOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4605 FARGO AVE, SKOKIE, IL 60076-3946
(312) 468-6685
Mailing address
4605 FARGO AVE, SKOKIE, IL 60076-3946
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-384390
IL
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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