Individual
AUDREY BAENZIGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
29854 OAK MEADOW DR, KINGSTON, IL 60145-8538
(815) 739-5244
(815) 895-2270
Mailing address
29854 OAK MEADOW DR, KINGSTON, IL 60145-8538
(815) 739-5244
(815) 895-2270
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-20703
IL
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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