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Individual

MS. TABITHA J WEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.T

Contact information

Practice address
11385 EDGEMERE TER, ROSCOE, IL 61073-8200
(815) 319-2933
Mailing address
11385 EDGEMERE TER, ROSCOE, IL 61073-8200
(815) 319-2933

Taxonomy

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

Other

Enumeration date
06/03/2013
Last updated
06/03/2013
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