Provider Demographics
NPI:1154169894
Name:MURRY, TOQUETTA (RBT)
Entity type:Individual
Prefix:
First Name:TOQUETTA
Middle Name:
Last Name:MURRY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:TOQUETTA
Other - Middle Name:
Other - Last Name:MURRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:3948 W CONGRESS PKWY APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-3106
Mailing Address - Country:US
Mailing Address - Phone:312-824-7964
Mailing Address - Fax:
Practice Address - Street 1:3948 W CONGRESS PKWY APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-3106
Practice Address - Country:US
Practice Address - Phone:312-824-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician