Individual
CONNIE TEMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12511 S PRINCETON AVE, CHICAGO, IL 60628-7224
(312) 826-1210
Mailing address
12511 S PRINCETON AVE, CHICAGO, IL 60628-7224
(312) 826-1210
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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