Frederick Blackmon II

NPI #1558166405 in Homewood, Illinois

Provider Information

NPI Number: 1558166405
Entity Type: Individual
Name: Frederick Blackmon II
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 14, 2025
Last Updated: Feb 14, 2025

Practice Location

Address: 17627 BRIAR AVE
City: Homewood
State: Illinois
ZIP Code: 60430-1006
Phone: (708) 465-8060

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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