Individual
COURTNEY NISAVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9023 S COMMERCIAL AVE, CHICAGO, IL 60617-4304
(312) 405-5763
Mailing address
9023 S COMMERCIAL AVE, CHICAGO, IL 60617-4304
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-40049
IL
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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