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General NPI Number Information
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NPI Number | 1427564947
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Entity Type | Individual
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Provider Name | DEBORA ESTER WALDER BA
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Gender | Female
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 12/20/2017
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Provider Practice Location Address
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Address Line | 6809 S CARPENTER ST
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City | CHICAGO
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State | IL
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Zip | 60621-1131
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Country | US
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Telephone | 773-550-0131
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Fax | 773-778-0018
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Provider Business Mailing Address
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Address Line | 6809 SO.CARPENTER 6535 SO.KEDZIE
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City | CHICAGO
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State | IL
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Zip | 60621
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Country | US
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Telephone | 773-550-0131
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Fax | 773-778-0018
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State | IL
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