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General NPI Number Information
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NPI Number | 1376409680
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Entity Type | Individual
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Provider Name | MYA PRECIOUS JUAL MAY
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Gender | Female
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 8700 S DANTE AVE
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City | CHICAGO
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State | IL
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Zip | 60619-7118
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Country | US
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Telephone | 833-717-4244
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Fax |
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Provider Business Mailing Address
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Address Line | 7706 S KINGSTON AVE APT 1E
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City | CHICAGO
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State | IL
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Zip | 60649-4766
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Country | US
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Telephone | 833-717-4244
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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 | RBT-25-486815
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License Number State | IL
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