Individual
JASMINE L GALLEGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
436 JULIAN ST, WAUKEGAN, IL 60085-4050
(262) 617-2581
Mailing address
436 JULIAN ST, WAUKEGAN, IL 60085-4050
(262) 617-2581
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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