Individual
JULIA DEATHERAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 FEDERAL DR, CRYSTAL LAKE, IL 60014
(779) 220-6340
Mailing address
32458 N RUSHMORE AVE, LAKEMOOR, IL 60051-6666
(815) 307-2501
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/05/2023
Last updated
01/11/2024
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