Individual
LESLIE JANNUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA# 1-18-33737
Contact information
Practice address
302 ANGELA CT, VERNON HILLS, IL 60061-1709
(847) 997-2296
Mailing address
302 ANGELA CT, VERNON HILLS, IL 60061-1709
(847) 997-2296
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33737
IL
106S00000X
Behavior Technician
16-23039
IL
Other
Enumeration date
05/14/2018
Last updated
02/07/2019
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