Individual
REGINA LEE GOLDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
555 W KINZIE ST, 2007, CHICAGO, IL 60654-5727
(847) 951-6115
Mailing address
555 W KINZIE ST, 2007, CHICAGO, IL 60654-5727
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
G435-7328-7728
IL
Other
Enumeration date
10/14/2009
Last updated
07/29/2011
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