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Keaira Dates

Behavior Technician in Chicago, IL. Individual provider (NPI-1).

NPI number1114698271
StatusActive
Last updated in NPPESSep 27, 2021

Details

NPI
1114698271
Entity type
Individual (NPI-1)
Name
Keaira Dates
Sex
Female
Sole proprietor
No
Enumeration date
Sep 27, 2021
Certification date
Sep 27, 2021
Last updated
Sep 27, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior TechnicianRBT-18-64737ILYes

Practice location

1409 W Carroll Ave
Chicago, IL 60607-1105

Phone 312-733-0883

Mailing address

1409 W Carroll Ave
Chicago, IL 60607-1105

Phone 312-733-0883

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