Individual
MS. JOANNA MARIE KOOISTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
6400 W BERTEAU AVE APT 502, CHICAGO, IL 60634-1488
(224) 251-0704
Mailing address
6400 W BERTEAU AVE APT 502, CHICAGO, IL 60634-1488
(224) 251-0704
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-6811
IL
Other
Enumeration date
09/11/2008
Last updated
07/25/2024
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