Individual provider · Type 1 NPI
Jaime Boudros Mossman
Developmental Therapist · Villa Park, IL
Practice location
32 S Charles Ave
Villa Park, IL 60181-2618
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | JB23770301P (IL) |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
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About NPI 1972624609
Jaime Boudros Mossman's National Provider Identifier is 1972624609, issued on Apr 2, 2007. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Villa Park, IL. The record was last updated on Jul 8, 2007.