Individual
GARY MICHAEL GOURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 S 700 E STE 2A, SALT LAKE CITY, UT 84102-2855
(801) 500-7441
Mailing address
515 S 700 E STE 2A, SALT LAKE CITY, UT 84102-2855
(801) 500-7441
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
UT
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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