Individual
JODI L OLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3921 PINTAIL DR, SPRINGFIELD, IL 62711-6738
(217) 622-0564
Mailing address
11401 BLUEGRASS PKWY, LOUISVILLE, KY 40299-2349
(217) 572-2286
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-136870
IL
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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