Most Relevant Information
Provider Data
| NPI Number: | 1003305590 |
| Provider Name: | GLORIA JEAN ERICK RBT 17-36284 |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 17-36284 |
Most Important Dates
| Enumeration Date: | 05/09/2018 |
| Last Updated: | 05/09/2018 |
Provider Practice Location
7357 W 103RD ST
PALOS HILLS
IL
604652054
Practice Location Phone/Fax
| Phone: | 7082120008 |
| Fax: |
Provider Mailing Location
7357 W 103RD ST
PALOS HILLS
IL
604652054
Provider Mailing Phone/Fax
| Phone: | 7082120008 |
| Fax: |