Individual
TINA ORA JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACHELORS DEGREE
Contact information
Practice address
1422 S 20TH AVE, MAYWOOD, IL 60153-1731
(773) 397-5182
Mailing address
1422 S 20TH AVE, MAYWOOD, IL 60153-1731
(773) 397-5182
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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