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General NPI Number Information
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NPI Number | 1245055946
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Entity Type | Individual
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Provider Name | DAKOTA MANDEL RBT
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 3295 N ARLINGTON HEIGHTS RD STE 107
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-1588
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Country | US
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Telephone | 224-206-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 204 E PRAIRIE ST APT 9
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City | MARENGO
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State | IL
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Zip | 60152-3107
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Country | US
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Telephone | 779-704-9095
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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