Provider Demographics
NPI:1659866770
Name:CAVANAUGH, YVONNE (RBT)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:CAVANAUGH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 MILDRED AVE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2917
Mailing Address - Country:US
Mailing Address - Phone:312-995-2653
Mailing Address - Fax:
Practice Address - Street 1:209 MILDRED AVE
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-2917
Practice Address - Country:US
Practice Address - Phone:312-995-2653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-01
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician