Individual
KAILEY RYANNE LUPARELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 W WASHINGTON ST, CHICAGO, IL 60602-1605
(708) 912-1903
Mailing address
2617 KENT DR, SPRINGFIELD, IL 62703-5046
(217) 491-8403
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-247708
IL
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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