Individual
MRS. ERICKA GISELLE PENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT 17-37783
Contact information
Practice address
1065 DARWIN DR, MACHESNEY PARK, IL 61115-1473
(815) 713-8520
Mailing address
1065 DARWIN DR, MACHESNEY PARK, IL 61115-1473
(815) 713-8520
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-37783
IL
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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