Luchinni Prabowo-Mandayo
Luchinni Prabowo-Mandayo is a Behavior Technician in Park Ridge, Illinois. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
444 N Northwest Hwy Ste 147Park Ridge, IL 60068-3263
Phone: (847) 610-9798
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|
Record details
| NPI number | 1801623152 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | September 18, 2024 |
| Last updated in NPPES | September 18, 2024 |
| Certification date | September 18, 2024 |
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