Individual
KAYSIE DOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11309 DISTINCTIVE DR, ORLAND PARK, IL 60467-9490
(708) 738-4019
Mailing address
1018 MOUNTAIN VIEW DR, JOLIET, IL 60432-0755
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-453541
IL
Other
Enumeration date
09/17/2025
Last updated
09/17/2025
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