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Individual

AMANDA JONDRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6 EAGLE CTR STE 1, O FALLON, IL 62269-1945
(844) 854-1116
Mailing address
401 GARESCHE ST, COLLINSVILLE, IL 62234-5324

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J536-0169-7790
DRIVERS LISCENSE
IL
Enumeration date
09/08/2020
Last updated
09/08/2020
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