Provider Demographics
NPI:1528557493
Name:SIEBERT-EINSLE, JULIE LYNN (RBT-17-45401)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:SIEBERT-EINSLE
Suffix:
Gender:F
Credentials:RBT-17-45401
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 AVALON CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-8574
Mailing Address - Country:US
Mailing Address - Phone:630-621-6345
Mailing Address - Fax:
Practice Address - Street 1:2435 AVALON CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60503-8574
Practice Address - Country:US
Practice Address - Phone:630-621-6345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT-17-45401106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician