MS. Mary Malisa Mathew

NPI #1669922647 in Wheaton, Illinois

Provider Information

NPI Number: 1669922647
Entity Type: Individual
Name: MS. Mary Malisa Mathew
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Oct 13, 2016
Last Updated: Jun 21, 2021

Practice Location

Address: 1725 S NAPERVILLE RD STE 110
City: Wheaton
State: Illinois
ZIP Code: 60189-5855
Phone: (815) 469-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Behavior Technician	106S00000X	Primary

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