Individual
ANGELICA GALLEGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA 1-21-48488
Contact information
Practice address
854 TECHNOLOGY WAY, LIBERTYVILLE, IL 60048-5350
(847) 816-7200
Mailing address
372 DORCHESTER LN, GRAYSLAKE, IL 60030-3429
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48488
IL
106S00000X
Behavior Technician
RBT-19-75290
IL
Other
Enumeration date
01/20/2019
Last updated
04/12/2021
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