Individual
MRS. KATHLEEN M GUYETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1812 S DEARBORN ST, 24, CHICAGO, IL 60616-1648
(847) 867-8752
Mailing address
1812 S DEARBORN ST, 24, CHICAGO, IL 60616-1648
(847) 867-8752
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CTY000267809
BLUECROSS BLUE SHIELD
IL
Enumeration date
02/09/2009
Last updated
02/09/2009
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