Individual
TAYLOR DANIELLE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2544 E 91ST ST, CHICAGO, IL 60617-4010
(219) 688-1425
Mailing address
2544 E 91ST ST, CHICAGO, IL 60617-4010
(219) 688-1425
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12042700
IL
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20190701662505
—
IL
Enumeration date
07/01/2019
Last updated
11/27/2023
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