Individual
MS. ALEXANDRA NICOLE ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1318 WAUKEGAN RD, GLENVIEW, IL 60025-3022
(866) 815-4145
Mailing address
1318 WAUKEGAN RD, GLENVIEW, IL 60025-3022
(847) 486-4145
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-321865
IL
Other
Enumeration date
01/26/2024
Last updated
01/26/2024
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