Jaquise C Land

NPI #1114614864 in Chicago, Illinois

Provider Information

NPI Number: 1114614864
Entity Type: Individual
Name: Jaquise C Land
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 21, 2023
Last Updated: Apr 21, 2023

Practice Location

Address: 8618 W CATALPA AVE STE 1106
City: Chicago
State: Illinois
ZIP Code: 60656-1108
Phone: (872) 810-9312

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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