Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003423393 |
---|---|
Provider Name | Valeria Gass |
First Address | Green Bay, WI 54311-5639 |
Second Address | Naperville, IL 60563-8472 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2020 |
Last Update Date | 30/09/2020 |