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Individual

JESSICA LAUREN BLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., BCBA

Contact information

Practice address
19056 HENRY DR, MOKENA, IL 60448-9302
(708) 995-5751
Mailing address
9400 S WINCHESTER AVE, CHICAGO, IL 60643-6350
(773) 316-3099

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11935455
IL

Other

Enumeration date
04/19/2019
Last updated
04/19/2019
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