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General NPI Number Information
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NPI Number | 1407776933
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Entity Type | Individual
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Provider Name | RUBY BARRAZA RBT
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Gender | Female
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 19150 88TH AVE
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City | MOKENA
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State | IL
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Zip | 60448-8135
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Country | US
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Telephone | 331-282-2005
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Fax |
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Provider Business Mailing Address
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Address Line | 14557 KARLOV AVE
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City | MIDLOTHIAN
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State | IL
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Zip | 60445-2711
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Country | US
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Telephone | 708-856-1791
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | IL
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