Individual
TIFFANY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5304 GRAND AVE, WESTERN SPRINGS, IL 60558-1838
(630) 430-2321
Mailing address
5304 GRAND AVE, WESTERN SPRINGS, IL 60558-1838
(630) 430-2321
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31709
IL
Other
Enumeration date
01/26/2012
Last updated
01/26/2021
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