Individual
JOHNNIE MAE JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8296
(847) 984-5689
Mailing address
24647 N MILWAUKEE AVE, VERNON HILLS, IL 60061-1567
(847) 377-8296
(847) 984-5689
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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