Maravilla, Kelly
Maravilla, Kelly is an individual health care provider with primary practice located at 1409 W Carroll Ave , Chicago IL 60607-1105. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Maravilla, Kelly can be contacted via phone (312) 733-0883.Contact Information
Primary practice address
1409 W Carroll Ave
Chicago IL 60607-1105
Phone: (312) 733-0883
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X | ||
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X | Illinois |
Profile Details
| NPI number | 1306352679 |
|---|---|
| LBN Legal business name | Maravilla, Kelly |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2017 |
| Last updated | Dec 21st, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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