Individual
MS. NICOLETTE PAIGE SUSRALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
16086 HARLEM AVE, TINLEY PARK, IL 60477-1612
(815) 469-1500
Mailing address
16086 HARLEM AVE, TINLEY PARK, IL 60477-1612
(708) 719-4288
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-81898
IL
106S00000X
Behavior Technician
RBT-22-203206
IL
Other
Enumeration date
05/07/2024
Last updated
06/12/2025
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