Individual
JATARA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 E 79TH ST, CHICAGO, IL 60619-4607
(773) 221-7171
Mailing address
1401 E 79TH ST, CHICAGO, IL 60619-4607
(773) 221-7171
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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