Individual
ANITTA REYNOLD PANIKKUTHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT-18-52795
Contact information
Practice address
6454 HATHAWAY LN, DOWNERS GROVE, IL 60516-2435
(630) 392-1433
Mailing address
6454 HATHAWAY LN, DOWNERS GROVE, IL 60516-2435
(630) 392-1433
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-52795
IL
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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