Individual
VANESSA GWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
435 GREENE 773 RD, PARAGOULD, AR 72450-9638
(870) 205-3188
Mailing address
435 GREENE 773 RD, PARAGOULD, AR 72450-9638
(870) 205-3188
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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