Individual provider · NPI-1

Chantel Black

Behavior Technician · Palos Heights, IL

NPI number1720829393
StatusActive
Last updated in NPPESJun 5, 2024

Details

NPI
1720829393
Entity type
Individual (NPI-1)
Name
Chantel Black
Sex
Female
Sole proprietor
No
Enumeration date
Jun 5, 2024
Certification date
Jun 5, 2024
Last updated
Jun 5, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

11755 Southwest Hwy
Palos Heights, IL 60463-1015

Phone 708-586-4239

Mailing address

11755 Southwest Hwy
Palos Heights, IL 60463-1015

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