Individual
KATHY ANN PUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 REVERE DR STE 120, NORTHBROOK, IL 60062-8005
(844) 247-7222
(847) 348-3706
Mailing address
704 EDGEWATER DR, MINOOKA, IL 60447-8928
(708) 577-9639
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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