Individual
AUDREY WHYBREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 EXECUTIVE PL STE 201, GENEVA, IL 60134-3805
(815) 223-2237
Mailing address
1250 EXECUTIVE PL STE 201, GENEVA, IL 60134-3805
(815) 223-2237
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-39472
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-17-39472
RBT
—
Enumeration date
12/16/2019
Last updated
12/16/2019
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