Individual
EDITH IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT-17-42921
Contact information
Practice address
1683 FIDDYMENT DR, ROMEOVILLE, IL 60446-5157
(815) 919-7309
Mailing address
1683 FIDDYMENT DR, ROMEOVILLE, IL 60446-5157
(815) 919-7309
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-42921
IL
Other
Enumeration date
05/18/2018
Last updated
05/18/2018
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