Individual
ANTONIA MARIE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 EMERSON ST RM 311, EVANSTON, IL 60201-3810
(612) 730-3861
Mailing address
630 EMERSON ST RM 311, EVANSTON, IL 60201-3810
(612) 730-3861
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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