Individual
CONSTANTINA MASTORACOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1765 N ELSTON AVE, CHICAGO, IL 60642-1501
(773) 630-4400
Mailing address
1765 N ELSTON AVE, CHICAGO, IL 60642-1501
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-67247
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/22/2019
Last updated
10/16/2023
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