NPI 1104194596
Equalla Agee
Practice location
- Address
- 19530 Kedzie Ave, Flossmoor, IL 60422-1778
- Phone
- (708) 754-8815
- Mailing address
- 17746 Oak Park Ave, Tinley Park, IL 60477-3936
Registered specialties
Behavior Analyst
Primary
Registry record
- NPI
- 1104194596
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 13 Dec 2011
- Record last updated
- 13 Dec 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.