Individual
ANIKA FONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1438 W BELMONT AVE STE 1, CHICAGO, IL 60657-2166
(312) 508-3645
Mailing address
1438 W BELMONT AVE STE 1, CHICAGO, IL 60657-2166
(312) 508-3645
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/30/2020
Last updated
05/11/2022
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