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Individual

KATRINA NESOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5705 WILLOW SPRINGS RD, COUNTRYSIDE, IL 60525-3478
(312) 965-2997
Mailing address
5705 WILLOW SPRINGS RD, COUNTRYSIDE, IL 60525-3478
(312) 965-2997

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/03/2023
Last updated
03/03/2023
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