Individual
MR. CHARLES SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS BCBA
Contact information
Practice address
3424 GROVE AVE, BERWYN, IL 60402-3636
(708) 307-1472
Mailing address
3424 GROVE AVE, BERWYN, IL 60402-3636
(708) 307-1472
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-19-38715
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
Other
Enumeration date
03/13/2015
Last updated
12/26/2019
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