Individual
MS. REBEKAH GROOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5315 N DAMEN AVE APT 1S, CHICAGO, IL 60625-1103
(540) 278-9814
Mailing address
5315 N DAMEN AVE APT 1S, CHICAGO, IL 60625-1103
(540) 278-9814
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133003330
VA
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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