Individual
HEAVEN BONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1716 CORPORATE XING STE 3, O FALLON, IL 62269-3734
(618) 226-4687
Mailing address
1500 S DOUGLAS RD STE 230, CORAL GABLES, FL 33134-4108
(844) 244-1818
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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